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Sample records for impulse control disorders

  1. Diagnosis and treatment of impulse control disorders in patients with movement disorders.

    Science.gov (United States)

    Mestre, Tiago A; Strafella, Antonio P; Thomsen, Teri; Voon, Valerie; Miyasaki, Janis

    2013-05-01

    Impulse control disorders are a psychiatric condition characterized by the failure to resist an impulsive act or behavior that may be harmful to self or others. In movement disorders, impulse control disorders are associated with dopaminergic treatment, notably dopamine agonists (DAs). Impulse control disorders have been studied extensively in Parkinson's disease, but are also recognized in restless leg syndrome and atypical Parkinsonian syndromes. Epidemiological studies suggest younger age, male sex, greater novelty seeking, impulsivity, depression and premorbid impulse control disorders as the most consistent risk factors. Such patients may warrant special monitoring after starting treatment with a DA. Various individual screening tools are available for people without Parkinson's disease. The Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease has been developed specifically for Parkinson's disease. The best treatment for impulse control disorders is prevention. However, after the development of impulse control disorders, the mainstay intervention is to reduce or discontinue the offending anti-Parkinsonian medication. In refractory cases, other pharmacological interventions are available, including neuroleptics, antiepileptics, amantadine, antiandrogens, lithium and opioid antagonists. Unfortunately, their use is only supported by case reports, small case series or open-label clinical studies. Prospective, controlled studies are warranted. Ongoing investigations include naltrexone and nicotine.

  2. Forensic Psychiatric Aspects of Impulse Control Disorders

    Directory of Open Access Journals (Sweden)

    Huseyin Soysal

    2015-03-01

    Full Text Available Impulse control disorders is an important psychiatric disorder group which draws attention in recent years. Attention deficit hyperactivity disorder and other classical disorders like pyromania, kleptomania, intermittent explosive disorder and compulsive buying could be evasuated under this topic. The aim of this article is to review forensic psychiatric aspects of impulse control disorders and evaluate the disorders in terms of their legal status. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2015; 7(1: 16-29

  3. Impulse control disorders are associated with multiple psychiatric symptoms in Parkinson's disease.

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    Jaakkola, Elina; Kaasinen, Valtteri; Siri, Chiara; Martikainen, Kirsti; Cilia, Roberto; Niemelä, Solja; Joutsa, Juho

    2014-01-01

    Impulse control disorders can have serious adverse consequences to the life of a patient with Parkinson's disease. Although impulse control disorders are common, a possible psychiatric comorbidity has not been fully characterized. The aim of this study was to investigate the psychiatric symptoms exhibited by Parkinson's disease patients with impulse control disorders. The study was conducted as a postal survey to patients in the registry of the Finnish Parkinson Association. A total of 290 Parkinson's disease patients were evaluated for impulse control disorders using the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease. Psychiatric symptoms were systematically screened using the Symptom Checklist 90. We found that 108 of the evaluated patients had one or more impulse control disorders. Patients with impulse control disorders had markedly higher scores for symptoms of psychoticism (Bonferroni corrected p disorder (p impulse control disorders. Impulse control disorders were shown to be independently associated with these symptoms. Patients with multiple impulse control disorders had higher scores for depression and obsessive-compulsive symptoms when compared with patients that exhibited only one impulse control disorder. COUNCLUSIONS: Our results confirm the previous observations that impulse control disorders in Parkinson's disease are linked with multiple psychiatric symptoms, including psychoticism, interpersonal sensitivity, obsessive-compulsive symptoms and depression. Clinicians treating these patients should acknowledge the concomitant psychiatric symptoms.

  4. Drug-induced impulse control disorders in Parkinson's disease.

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    Reiff, J; Jost, W H

    2011-05-01

    Dopamine replacement treatment with excessive or aberrant dopamine receptor stimulation can cause behavioral disturbances in Parkinson's disease, comprising dopamine dysregulation syndrome, punding, and impulse control disorders. Common impulse control disorders are compulsive buying, pathological gambling, binge eating, hypersexuality, and compulsive reckless driving.

  5. Pathological gambling: an impulse control disorder? Measurement of impulsivity using neurocognitive tests.

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    Dannon, Pinhas N; Shoenfeld, Netta; Rosenberg, Oded; Kertzman, Semion; Kotler, Moshe

    2010-04-01

    Pathological gambling is classified in the DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders) and in the ICD-10 (International Classification of Disease) as an impulse control disorder. The association between impulsivity and pathological gambling remains a matter of debate: some researchers find high levels of impulsivity within pathological gamblers, others report no difference compared to controls, and yet others even suggest that it is lower. In this review we examine the relationship between pathological gambling and impulsivity assessed by various neurocognitive tests. These tests--the Stroop task, the Stop Signal Task, the Matching Familiar Figures Task, the Iowa Gambling Task, the Wisconsin Card Sorting Test, the Tower of London test, and the Continuous Performance Test--demonstrated less impulsivity in gambling behavior. The differences in performance between pathological gamblers and healthy controls on the neurocognitive tasks could be due to addictive behavior features rather than impulsive behavior.

  6. Depression in university students: associations with impulse control disorders.

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    Leppink, Eric W; Lust, Katherine; Grant, Jon E

    2016-09-01

    The purpose of this study was to assess the implications of depression in a sample of university students, particularly relating to impulse control disorders. While previous studies have shown high rates of depression among university students, no study to date has assessed whether levels of depression show associations with the incidence of impulse control disorders in this population. In all, 6000 students participated in the College Student Computer Use Survey. A total of 1717 students completed the scales of interest for this analysis. Participants were assigned to groups based on depression scores: severe (N = 75), mild/moderate (N = 647) and none (N = 995). The three groups were assessed using analysis of variance (ANOVA) or chi-square test. A multinomial logistic regression analysis was used to elucidate associations between depression and impulse control disorder diagnoses. Groups differed across demographic, health and academic variables. The severe depression group reported higher rates of skin-picking disorder, compulsive sexual behaviour and compulsive buying. Results suggest a significant association between depression and impulse control disorders. One possibility is that a facet of impulsivity contributes to both problems, which could be important information for clinicians. Future studies will need to clarify the exact nature of the relationship between depression and impulse control disorders.

  7. Dopamine and Impulse Control Disorders in Parkinson's Disease

    NARCIS (Netherlands)

    Weintraub, Daniel

    2008-01-01

    There is an increasing awareness that impulse control disorders (ICDs), including compulsive gambling, buying, sexual behavior, and eating, can occur as a complication of Parkinson's disease (PD). In addition, other impulsive or compulsive disorders have been reported to occur, including dopamine

  8. Impulse control disorder comorbidity among patients with bipolar I disorder.

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    Karakus, Gonca; Tamam, Lut

    2011-01-01

    Impulsivity is associated with mood instability, behavioral problems, and action without planning in patients with bipolar disorder. Increased impulsivity levels are reported at all types of mood episodes. This association suggests a high comorbidity between impulse control disorders (ICDs) and bipolar disorder. The aim of this study is to compare the prevalence of ICDs and associated clinical and sociodemographic variables in euthymic bipolar I patients. A total of 124 consecutive bipolar I patients who were recruited from regular attendees from the outpatient clinic of our Bipolar Disorder Unit were included in the study. All patients were symptomatically in remission. Diagnosis of bipolar disorder was confirmed using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Impulse control disorders were investigated using the modified version of the Minnesota Impulsive Disorders Interview. Impulsivity was measured with the Barratt Impulsiveness Scale Version 11. Furthermore, all patients completed the Zuckerman Sensation-Seeking Scale Form V. The prevalence rate of all comorbid ICDs in our sample was 27.4% (n = 34). The most common ICD subtype was pathologic skin picking, followed by compulsive buying, intermittent explosive disorder, and trichotillomania. There were no instances of pyromania or compulsive sexual behavior. There was no statistically significant difference between the sociodemographic characteristics of bipolar patients with and without ICDs with regard to age, sex, education level, or marital status. Comorbidity of alcohol/substance abuse and number of suicide attempts were higher in the ICD(+) group than the ICD(-) group. Length of time between mood episodes was higher in the ICD(-) group than the ICD(+) group. There was a statistically significant difference between the total number of mood episodes between the 2 groups, but the number of depressive episodes was higher in the ICD(+) patients

  9. Intrinsic brain connectivity predicts impulse control disorders in patients with Parkinson's disease.

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    Tessitore, Alessandro; De Micco, Rosa; Giordano, Alfonso; di Nardo, Federica; Caiazzo, Giuseppina; Siciliano, Mattia; De Stefano, Manuela; Russo, Antonio; Esposito, Fabrizio; Tedeschi, Gioacchino

    2017-12-01

    Impulse control disorders can be triggered by dopamine replacement therapies in patients with PD. Using resting-state functional MRI, we investigated the intrinsic brain network connectivity at baseline in a cohort of drug-naive PD patients who successively developed impulse control disorders over a 36-month follow-up period compared with patients who did not. Baseline 3-Tesla MRI images of 30 drug-naive PD patients and 20 matched healthy controls were analyzed. The impulse control disorders' presence and severity at follow-up were assessed by the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease Rating Scale. Single-subject and group-level independent component analysis was used to investigate functional connectivity differences within the major resting-state networks. We also compared internetwork connectivity between patients. Finally, a multivariate Cox regression model was used to investigate baseline predictors of impulse control disorder development. At baseline, decreased connectivity in the default-mode and right central executive networks and increased connectivity in the salience network were detected in PD patients with impulse control disorders at follow-up compared with those without. Increased default-mode/central executive internetwork connectivity was significantly associated with impulse control disorders development (P impulse control disorders while on dopaminergic treatment. We hypothesize that these divergent cognitive and limbic network connectivity changes could represent a potential biomarker and an additional risk factor for the emergence of impulse control disorders. © 2017 International Parkinson and Movement Disorder Society. © 2017 International Parkinson and Movement Disorder Society.

  10. Impulse control disorders and depression in Finnish patients with Parkinson's disease.

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    Joutsa, Juho; Martikainen, Kirsti; Vahlberg, Tero; Voon, Valerie; Kaasinen, Valtteri

    2012-02-01

    Impulse control disorders occur frequently in patients with Parkinson's disease. However, the frequencies have been investigated mainly in patients from secondary or tertiary care centers, and thus, the prevalence rates in general community are not known. Our objective was to study the prevalence rates of impulse control disorders and related factors in a large, non-selected sample of Parkinson's disease patients. We conducted a cross-sectional survey among Parkinson's disease patients from Finnish Parkinson Association [n = 575; 365 men, 240 women, median age 64 (range 43-90) years]. Problem and pathological gambling were estimated with the South Oaks Gambling Screen, risk for impulse control disorders with the validated Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease, and depression with the Beck Depression Inventory. The frequency of pathological gambling was 7.0%. The overall frequency of a positive screen for an impulse control disorder was 34.8%, and 12.5% of the patients screened positive for multiple disorders. Depressive symptoms were statistically the most important factor in explaining variance in impulse control disorder risk, even more than sex, age, age of disease onset, alcohol use, or medication. The high proportion of patients screened positive for impulse control disorders in a non-selected sample emphasize the importance of routine screening of these disorders in Parkinson's disease. Pathological gambling prevalence in Parkinson's disease is seven times higher than in the general population in Finland. The results underline the importance of depression in impulse control disorders associated with Parkinson's disease. Copyright © 2011 Elsevier Ltd. All rights reserved.

  11. Impulse control disorders in Parkinson's disease: decreased striatal dopamine transporter levels.

    Science.gov (United States)

    Voon, Valerie; Rizos, Alexandra; Chakravartty, Riddhika; Mulholland, Nicola; Robinson, Stephanie; Howell, Nicholas A; Harrison, Neil; Vivian, Gill; Ray Chaudhuri, K

    2014-02-01

    Impulse control disorders are commonly associated with dopaminergic therapy in Parkinson's disease (PD). PD patients with impulse control disorders demonstrate enhanced dopamine release to conditioned cues and a gambling task on [(11)C]raclopride positron emission tomography (PET) imaging and enhanced ventral striatal activity to reward on functional MRI. We compared PD patients with impulse control disorders and age-matched and gender-matched controls without impulse control disorders using [(123)I]FP-CIT (2β-carbomethoxy-3β-(4-iodophenyl)tropane) single photon emission computed tomography (SPECT), to assess striatal dopamine transporter (DAT) density. The [(123)I]FP-CIT binding data in the striatum were compared between 15 PD patients with and 15 without impulse control disorders using independent t tests. Those with impulse control disorders showed significantly lower DAT binding in the right striatum with a trend in the left (right: F(1,24)=5.93, p=0.02; left: F(1,24)=3.75, p=0.07) compared to controls. Our findings suggest that greater dopaminergic striatal activity in PD patients with impulse control disorders may be partly related to decreased uptake and clearance of dopamine from the synaptic cleft. Whether these findings are related to state or trait effects is not known. These findings dovetail with reports of lower DAT levels secondary to the effects of methamphetamine and alcohol. Although any regulation of DAT by antiparkinsonian medication appears to be modest, PD patients with impulse control disorders may be differentially sensitive to regulatory mechanisms of DAT expression by dopaminergic medications.

  12. Dopamine agonists and risk: impulse control disorders in Parkinson's disease.

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    Voon, Valerie; Gao, Jennifer; Brezing, Christina; Symmonds, Mkael; Ekanayake, Vindhya; Fernandez, Hubert; Dolan, Raymond J; Hallett, Mark

    2011-05-01

    Impulse control disorders are common in Parkinson's disease, occurring in 13.6% of patients. Using a pharmacological manipulation and a novel risk taking task while performing functional magnetic resonance imaging, we investigated the relationship between dopamine agonists and risk taking in patients with Parkinson's disease with and without impulse control disorders. During functional magnetic resonance imaging, subjects chose between two choices of equal expected value: a 'Sure' choice and a 'Gamble' choice of moderate risk. To commence each trial, in the 'Gain' condition, individuals started at $0 and in the 'Loss' condition individuals started at -$50 below the 'Sure' amount. The difference between the maximum and minimum outcomes from each gamble (i.e. range) was used as an index of risk ('Gamble Risk'). Sixteen healthy volunteers were behaviourally tested. Fourteen impulse control disorder (problem gambling or compulsive shopping) and 14 matched Parkinson's disease controls were tested ON and OFF dopamine agonists. Patients with impulse control disorder made more risky choices in the 'Gain' relative to the 'Loss' condition along with decreased orbitofrontal cortex and anterior cingulate activity, with the opposite observed in Parkinson's disease controls. In patients with impulse control disorder, dopamine agonists were associated with enhanced sensitivity to risk along with decreased ventral striatal activity again with the opposite in Parkinson's disease controls. Patients with impulse control disorder appear to have a bias towards risky choices independent of the effect of loss aversion. Dopamine agonists enhance sensitivity to risk in patients with impulse control disorder possibly by impairing risk evaluation in the striatum. Our results provide a potential explanation of why dopamine agonists may lead to an unconscious bias towards risk in susceptible individuals.

  13. Impulsivity in borderline personality disorder: a matter of disturbed impulse control or a facet of emotional dysregulation?

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    Sebastian, Alexandra; Jacob, Gitta; Lieb, Klaus; Tüscher, Oliver

    2013-02-01

    Impulsivity is regarded as a clinical, diagnostic and pathophysiological hallmark of borderline personality disorder (BPD). Self-report measures of impulsivity consistently support the notion of higher impulsive traits in BPD patients as compared to healthy control subjects. Laboratory tests of impulsivity, i.e. neuropsychological tests of impulse control render weak and inconsistent results both across different cognitive components of impulse control and within the same cognitive component of impulse control. One important factor worsening impulsive behaviors and impulse control deficits in BPD is comorbid attention-deficit/hyperactivity disorder (ADHD). In addition, emotional dysregulation interacts with impulse control especially for BPD salient emotions. In sum, although basic mechanisms of impulse control seem not to be disturbed in BPD, clinically well observed impulsive behaviors may be explained by comorbid ADHD or may be the consequence of dysregulation of BPD salient emotions.

  14. Impulse control disorder and rapid eye movement sleep behavior disorder in Parkinson's disease.

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    Bayard, Sophie; Dauvilliers, Yves; Yu, Huan; Croisier-Langenier, Muriel; Rossignol, Alexia; Charif, Mahmoud; Geny, Christian; Carlander, Bertrand; Cochen De Cock, Valérie

    2014-12-01

    The relationship between ICD and RBD is still not yet understood and the results from the current literature are contradictory in PD. We aimed to explore the association between rapid eye movement (REM) sleep behavior disorder (RBD) and impulse control disorder in Parkinson's disease. Ninety-eight non-demented patients with Parkinson's disease underwent one night of video-polysomnography recording. The diagnosis of RBD was established according to clinical and polysomnographic criteria. Impulse control disorders were determined by a gold standard, semi-structured diagnostic interview. Half of the patients (n = 49) reported clinical history of RBD while polysomnographic diagnosis of RBD was confirmed in 31.6% of the patients (n = 31). At least one impulse control disorder was identified in 21.4% of patients, 22.6% with RBD and 20.9% without. Logistic regression controlling for potential confounders indicated that both clinical RBD (OR = 0.34, 95% CI = 0.07-1.48, P = 0.15) and polysomnographic confirmed RBD diagnoses (OR = 0.1.28, 95% CI = 0.31-5.33, P = 0.34) were not associated with impulse control disorder. In Parkinson's disease, REM Sleep Behavior Disorder is not associated with impulse control disorder. The results of our study do not support the notion that PSG-confirmed RBD and ICD share a common pathophysiology. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Frontal dysfunctions of impulse control - a systematic review in borderline personality disorder and attention-deficit/hyperactivity disorder.

    Science.gov (United States)

    Sebastian, Alexandra; Jung, Patrick; Krause-Utz, Annegret; Lieb, Klaus; Schmahl, Christian; Tüscher, Oliver

    2014-01-01

    Disorders such as borderline personality disorder (BPD) or attention-deficit/hyperactivity disorder (ADHD) are characterized by impulsive behaviors. Impulsivity as used in clinical terms is very broadly defined and entails different categories including personality traits as well as different cognitive functions such as emotion regulation or interference resolution and impulse control. Impulse control as an executive function, however, is neither cognitively nor neurobehaviorally a unitary function. Recent findings from behavioral and cognitive neuroscience studies suggest related but dissociable components of impulse control along functional domains like selective attention, response selection, motivational control, and behavioral inhibition. In addition, behavioral and neural dissociations are seen for proactive vs. reactive inhibitory motor control. The prefrontal cortex with its sub-regions is the central structure in executing these impulse control functions. Based on these concepts of impulse control, neurobehavioral findings of studies in BPD and ADHD were reviewed and systematically compared. Overall, patients with BPD exhibited prefrontal dysfunctions across impulse control components rather in orbitofrontal, dorsomedial, and dorsolateral prefrontal regions, whereas patients with ADHD displayed disturbed activity mainly in ventrolateral and medial prefrontal regions. Prefrontal dysfunctions, however, varied depending on the impulse control component and from disorder to disorder. This suggests a dissociation of impulse control related frontal dysfunctions in BPD and ADHD, although only few studies are hitherto available to assess frontal dysfunctions along different impulse control components in direct comparison of these disorders. Yet, these findings might serve as a hypothesis for the future systematic assessment of impulse control components to understand differences and commonalities of prefrontal cortex dysfunction in impulsive disorders.

  16. The Neurobiology and Genetics of Impulse Control Disorders: Relationships to Drug Addictions

    Science.gov (United States)

    Brewer, Judson A.; Potenza, Marc N.

    2008-01-01

    Impulse control disorders (ICDs), including pathological gambling, trichotillomania, kleptomania and others, have been conceptualized to lie along an impulsive-compulsive spectrum. Recent data have suggested that these disorders may be considered addictions. Here we review the genetic and neuropathological bases of the impulse control disorders and consider the disorders within these non-mutually exclusive frameworks. PMID:17719013

  17. Minnesota Impulse Disorders Interview (MIDI): Validation of a structured diagnostic clinical interview for impulse control disorders in an enriched community sample.

    Science.gov (United States)

    Chamberlain, Samuel R; Grant, Jon E

    2018-05-08

    Disorders of impulsivity are common, functionally impairing, and highly relevant across different clinical and research settings. Few structured clinical interviews for the identification and diagnosis of impulse control disorders exist, and none have been validated in a community sample in terms of psychometric properties. The Minnesota Impulse control disorders Interview (MIDI v2.0) was administered to an enriched sample of 293 non-treatment seeking adults aged 18-35 years, recruited using media advertisements in two large US cities. In addition to the MIDI, participants undertook extended clinical interview for other mental disorders, the Barratt impulsiveness questionnaire, and the Padua obsessive-compulsive inventory. The psychometric properties of the MIDI were characterized. In logistic regression, the MIDI showed good concurrent validity against the reference measures (versus gambling disorder interview, p  0.05). Test re-test reliability was excellent (0.95). The MIDI has good psychometric properties and thus may be a valuable interview tool for clinical and research studies involving impulse control disorders. Further research is needed to better understanding the optimal diagnostic classification and neurobiology of these neglected disorders. Crown Copyright © 2018. Published by Elsevier B.V. All rights reserved.

  18. Frontal dysfunctions of impulse control – a systematic review in borderline personality disorder and attention deficit hyperactivity disorder

    Directory of Open Access Journals (Sweden)

    Alexandra eSebastian

    2014-09-01

    Full Text Available Disorders such as borderline personality disorder (BPD or attention-deficit/hyperactivity disorder (ADHD are characterized by impulsive behaviors. Impulsivity as used in clinical terms is very broadly defined and entails different categories including personality traits as well as different cognitive functions such as emotion regulation or interference resolution and impulse control. Impulse control as an executive function, however, is neither cognitively nor neurobehaviorally a unitary function. Recent findings from behavioral and cognitive neuroscience studies suggest related but dissociable components of impulse control along functional domains like selective attention, response selection, motivational control and behavioral inhibition. In addition, behavioral and neural dissociations are seen for proactive versus reactive inhibitory motor control. The prefrontal cortex with its sub-regions is the central structure in executing these impulse control functions. Based on these concepts of impulse control, neurobehavioral findings of studies in BPD and ADHD were reviewed and systematically compared. Overall, BPD patients exhibited prefrontal dysfunctions across impulse control components rather in orbitofrontal, dorsomedial and dorsolateral prefrontal regions, whereas ADHD patients displayed disturbed activity mainly in ventrolateral and medial prefrontal regions. Prefrontal dysfunctions, however, varied depending on the impulse control component and from disorder to disorder. This suggests a dissociation of impulse control related frontal dysfunctions in BPD and ADHD, although only few studies are hitherto available to assess frontal dysfunctions along different impulse control components in direct comparison of these disorders. Yet, these findings might serve as a hypothesis for the future systematic assessment of impulse control components to understand differences and commonalities of prefrontal cortex dysfunction in impulsive disorders.

  19. Impulse control disorders and levodopa-induced dyskinesias in Parkinson's disease: an update.

    Science.gov (United States)

    Voon, Valerie; Napier, T Celeste; Frank, Michael J; Sgambato-Faure, Veronique; Grace, Anthony A; Rodriguez-Oroz, Maria; Obeso, Jose; Bezard, Erwan; Fernagut, Pierre-Olivier

    2017-03-01

    Dopaminergic medications used in the treatment of patients with Parkinson's disease are associated with motor and non-motor behavioural side-effects, such as dyskinesias and impulse control disorders also known as behavioural addictions. Levodopa-induced dyskinesias occur in up to 80% of patients with Parkinson's after a few years of chronic treatment. Impulse control disorders, including gambling disorder, binge eating disorder, compulsive sexual behaviour, and compulsive shopping occur in about 17% of patients with Parkinson's disease on dopamine agonists. These behaviours reflect the interactions of the dopaminergic medications with the individual's susceptibility, and the underlying neurobiology of Parkinson's disease. Parkinsonian rodent models show enhanced reinforcing effects of chronic dopaminergic medication, and a potential role for individual susceptibility. In patients with Parkinson's disease and impulse control disorders, impairments are observed across subtypes of decisional impulsivity, possibly reflecting uncertainty and the relative balance of rewards and losses. Impairments appear to be more specific to decisional than motor impulsivity, which might reflect differences in ventral and dorsal striatal engagement. Emerging evidence suggests impulse control disorder subtypes have dissociable correlates, which indicate that individual susceptibility predisposes towards the expression of different behavioural subtypes and neurobiological substrates. Therapeutic interventions to treat patients with Parkinson's disease and impulse control disorders have shown efficacy in randomised controlled trials. Large-scale studies are warranted to identify individual risk factors and novel therapeutic targets for these diseases. Mechanisms underlying impulse control disorders and dyskinesias could provide crucial insights into other behavioural symptoms in Parkinson's disease and addictions in the general population. Copyright © 2017 Elsevier Ltd. All rights

  20. Risk of Gambling Disorder and Impulse Control Disorder With Aripiprazole, Pramipexole, and Ropinirole: A Pharmacoepidemiologic Study.

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    Etminan, Mahyar; Sodhi, Mohit; Samii, Ali; Procyshyn, Ric M; Guo, Michael; Carleton, Bruce C

    2017-02-01

    Recently, the US Food and Drug Administration issued a warning regarding the potential risk of gambling disorder, but large epidemiologic studies are lacking. We used a large health claims database from the United States and conducted a nested case-control study. Cases were defined as subjects newly diagnosed with gambling disorder or impulse control disorder. For each case, 10 controls were selected and matched to cases by age and follow-up time and calendar time. Adjusted rate ratios were computed with conditional logistic regression. There are 355 cases of gambling disorder and 3550 controls along with 4341 cases of impulse control disorder and 43,410 corresponding controls. After adjusting for confounders, users of aripiprazole demonstrated an increased risk of pathologic gambling (rate ratio [RR], 5.23; 95% confidence interval [CI], 1.78-15.38) and impulse control disorder (RR, 7.71; 95% CI, 5.81-10.34). The risk was also elevated for pramipexole or ropinirole for both gambling disorder and impulse control disorder (RR, 7.61; 95% CI, 2.75-21.07; RR, 3.28; 95% CI, 2.31-4.66, respectively). Our study confirms an association between aripiprazole, pramipexole, or ropinirole and impulse control disorder and gambling disorder.

  1. Imaging impulse control disorders in Parkinson's disease and their relationship to addiction.

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    Ray, Nicola J; Strafella, Antonio P

    2013-04-01

    Established substance addictions and impulse control disorders (ICDs) such as pathological gambling share similar underlying neurobiology, and recent data extends these commonalities to the risk factors that increase an individuals' susceptibility to develop such behaviours. In Parkinson's disease (PD), impulse control disorders (ICDs) are increasingly recognised to develop after patients begin dopamine (DA) restoration therapy, in particular DA agonists. In both the PD and non-PD population, more impulsive individuals are at increased risk for impulse control disorders. Here, we review the neuroimaging data confirming the connection between addiction and ICDs, and revealing how DA agonists might cause specific alterations of basal ganglia and cortical function that vary as a function of an individuals' propensity for impulsivity.

  2. Impulse control disorders in advanced Parkinson's disease with dyskinesia: The ALTHEA study.

    Science.gov (United States)

    Biundo, Roberta; Weis, Luca; Abbruzzese, Giovanni; Calandra-Buonaura, Giovanna; Cortelli, Pietro; Jori, Maria Cristina; Lopiano, Leonardo; Marconi, Roberto; Matinella, Angela; Morgante, Francesca; Nicoletti, Alessandra; Tamburini, Tiziano; Tinazzi, Michele; Zappia, Mario; Vorovenci, Ruxandra Julia; Antonini, Angelo

    2017-11-01

    Impulse control disorders and dyskinesia are common and disabling complications of dopaminergic treatment in Parkinson's disease. They may coexist and are possibly related. The objectives of this study were to assess the frequency and severity of impulse control disorders in Parkinson's disease patients with dyskinesia. The ALTHEA study enrolled 251 Parkinson's disease patients with various degrees of dyskinesia severity from 11 movement disorders centers in Italy. Each patient underwent a comprehensive assessment including Unified Dyskinesia Rating Scale and the Questionnaire for Impulsive Compulsive Disorders in Parkinson Disease-Rating Scale. There was an overall 55% frequency of impulse control disorder and related behaviors (36% were clinically significant). The positive patients were younger at disease diagnosis and onset and had higher Unified Dyskinesia Rating Scale historical and total score (P = 0.001 and P = 0.02, respectively, vs negative). There was an increased frequency of clinically significant impulse control disorders in patients with severe dyskinesia (P = 0.013), a positive correlation between the questionnaire total score and dopamine agonist dose (P = 0.018), and a trend with levodopa dose. More than half of Parkinson's disease patients with dyskinesia have impulse control disorders and related behaviors, which are frequently clinically significant. Dopaminergic therapy total dose is associated with their severity. Clinicians should carefully assess patients with maladaptive behaviors and dyskinesia because they do not properly evaluate their motor and nonmotor status. © 2017 International Parkinson and Movement Disorder Society. © 2017 International Parkinson and Movement Disorder Society.

  3. Frontal dysfunctions of impulse control – a systematic review in borderline personality disorder and attention deficit hyperactivity disorder

    OpenAIRE

    Alexandra eSebastian; Patrick eJung; Annegret eKrause-Utz; Klaus eLieb; Christian eSchmahl; Oliver eTuescher; Oliver eTuescher

    2014-01-01

    Disorders such as borderline personality disorder (BPD) or attention-deficit/hyperactivity disorder (ADHD) are characterized by impulsive behaviors. Impulsivity as used in clinical terms is very broadly defined and entails different categories including personality traits as well as different cognitive functions such as emotion regulation or interference resolution and impulse control. Impulse control as an executive function, however, is neither cognitively nor neurobehaviorally a unitary fu...

  4. Frontal Dysfunctions of Impulse Control – A Systematic Review in Borderline Personality Disorder and Attention-Deficit/Hyperactivity Disorder

    OpenAIRE

    Sebastian, Alexandra; Jung, Patrick; Krause-Utz, Annegret; Lieb, Klaus; Schmahl, Christian; Tüscher, Oliver

    2014-01-01

    Disorders such as borderline personality disorder (BPD) or attention-deficit/hyperactivity disorder (ADHD) are characterized by impulsive behaviors. Impulsivity as used in clinical terms is very broadly defined and entails different categories including personality traits as well as different cognitive functions such as emotion regulation or interference resolution and impulse control. Impulse control as an executive function, however, is neither cognitively nor neurobehaviorally a unitary fu...

  5. Dopamine agonists and risk: impulse control disorders in Parkinson's; disease

    OpenAIRE

    Voon, Valerie; Gao, Jennifer; Brezing, Christina; Symmonds, Mkael; Ekanayake, Vindhya; Fernandez, Hubert; Dolan, Raymond J.; Hallett, Mark

    2011-01-01

    Impulse control disorders are common in Parkinson's; disease, occurring in 13.6% of patients. Using a pharmacological manipulation and a novel risk taking task while performing functional magnetic resonance imaging, we investigated the relationship between dopamine agonists and risk taking in patients with Parkinson's; disease with and without impulse control disorders. During functional magnetic resonance imaging, subjects chose between two choices of equal expected value: a ‘Sure’ choice an...

  6. Tourette's disease with impulse control disorder

    OpenAIRE

    Raj, Rajnish; Sidhu, Balwant Singh

    2011-01-01

    We report a case of Tourette's disease (TD) with impulse control disorder which is rare;these type of patients are prone to rage attack and explosive outbursts in the childhood and adolescence which can be detrimental. Hence, a case is reported to understand the phenomenology of its co-morbidity in TD.

  7. Depression, Impulse Control Disorder, and Life Style According to Smartphone Addiction.

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    Kim, E Y; Joo, S W; Han, S J; Kim, M J; Choi, S Y

    2017-01-01

    We examined depression, impulse control disorder, and life style by degree of smartphone addiction. Chi-square tests and ANOVA were used to identify significant variables. CART was used to generate a decision making diagram of variables affecting smartphone addiction. The severe smartphone addiction group had rates of depression and impulse control disorder than the initial smartphone group.

  8. Impulse control disorders in Chinese Parkinson's disease patients: the effect of ergot derived dopamine agonist.

    Science.gov (United States)

    Auyeung, M; Tsoi, T H; Tang, W K; Cheung, C M; Lee, C N; Li, R; Yeung, Eric

    2011-09-01

    We studied the prevalence and related risk factors of impulse control disorders in Chinese Parkinson's disease patients. We screened all non-demented Parkinson's disease patients attending our Parkinson's disease clinic from August 2009 to March 2010. The clinical characteristics of patients with impulse control disorders and those without were compared. Of the 213 PD subjects screened, 15 (7.0%) with impulse control disorders were identified. Fourteen of these subjects were on both a dopamine agonist and Levodopa, and one was on Levodopa alone. Of the fourteen subjects on both a dopamine agonist and Levodopa, eleven were on bromocriptine and Levodopa; 10.5% of the subjects exposed to bromocriptine had impulse control disorder. Upon multivariate analysis, dose of dopamine agonist used, young age at onset of Parkinson's disease and a history of anxiety or depression were independent predictors for developing impulse control disorders. 7% of our Chinese PD subjects had impulse control disorders. When young Parkinson's disease patients with a history of anxiety or depression are treated with high dose of DA, they are at risk of developing impulse control disorders. Copyright © 2011 Elsevier Ltd. All rights reserved.

  9. Losing control: assaultive behavior as a predictor of impulse control disorders in young adults.

    Science.gov (United States)

    Leppink, Eric; Odlaug, Brian L; Lust, Katherine; Christenson, Gary; Derbyshire, Katherine; Grant, Jon E

    2014-11-01

    Assaultive behaviors are common among young people and have been associated with a range of other unhealthy, impulsive behaviors such as substance use and problem gambling. This study sought to determine the predictive ability of single assaultive incidents for impulse control disorders, an association that has yet to be examined, especially in young adults. The authors conducted a university-wide email survey in the spring of 2011 on 6000 university students. The survey examined assaultive behavior and associated mental health variables (using a clinically validated screening instrument, the Minnesota Impulsive Disorders Interview), stress and mood states, and psychosocial functioning. The rate of response was 35.1% (n=2108). 109 (5.9%) participants reported that they had assaulted another person or destroyed property at some time in their lives. Compared with respondents without lifetime assaultive behavior, those with a history of assaultive or destructive behavior reported more depressive symptoms, more stress, and higher rates of a range of impulse control disorders (intermittent explosive disorder, compulsive sexual behavior, compulsive buying, and skin picking disorder). Assaultive behavior appears fairly common among college students and is associated with symptoms of depression and impulse control disorders. Significant distress and diminished behavioral control suggest that assaultive behaviors may often be associated with significant morbidity. Additional research is needed to develop specific prevention and treatment strategies for young adults attending college who report problems with assaultive behaviors. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. Impulse control disorders and levodopa-induced dyskinesias in Parkinson's disease: an update

    OpenAIRE

    Voon, V; Napier, TC; Frank, MJ; Sgambato-Faure, V; Grace, AA; Rodriguez-Oroz, M; Obeso, J; Bezard, E; Fernagut, P-O

    2017-01-01

    Dopaminergic medications used in the treatment of patients with Parkinson's disease are associated with motor and non-motor behavioural side-effects, such as dyskinesias and impulse control disorders also known as behavioural addictions. Levodopa-induced dyskinesias occur in up to 80% of patients with Parkinson's after a few years of chronic treatment. Impulse control disorders, including gambling disorder, binge eating disorder, compulsive sexual behaviour, and compulsive shopping occur in a...

  11. Impulse control disorders in Parkinson's disease

    Directory of Open Access Journals (Sweden)

    HAN Xun

    2013-08-01

    Full Text Available Impulse control disorders (ICDs in Parkinson's disease (PD are common with a frequency of 13.61% , which are associated with impaired functioning and with depressive, anxiety and obsessive symptoms, novelty seeking and impulsivity. These behaviors have a bad influence on PD patients in the quality of life. Different behavioral subtypes suggest pathophysiological differences. Recent large scale studies and converging findings are beginning to provide an understanding of mechanisms underlying ICDs in PD which can guide the prevention of these behaviors and optimize therapeutic approaches. This paper will take a review on the recent advances in the epidemiology, risk factors, pathophysiology, diagnosis and therapy of ICDs in PD.

  12. Effects of dopamine agonist dose and gender on the prognosis of impulse control disorders in Parkinson's disease.

    Science.gov (United States)

    Joutsa, Juho; Martikainen, Kirsti; Vahlberg, Tero; Kaasinen, Valtteri

    2012-12-01

    Cross-sectional studies have demonstrated that Parkinson's disease patients have an increased risk of impulse control disorders, and that the disorders frequently co-exist with depressive symptoms. There have been no previous large-scale prospective studies investigating predictive and prognostic factors of these disorders. A population of 290 Parkinson's disease patients was studied at baseline and approximately 15 months later. The same screening methodology was used at both time-points (demographic and medication data together with the Questionnaire for Impulsive-compulsive Disorders in Parkinson's disease and the Beck Depression Inventory). The data was analyzed separating patients with and without impulse control disorders at baseline to obtain clinically useful prognostic factors. In patients who had impulse control disorders at baseline (n = 119), high dopamine agonist dose was associated with the presence of disorders at follow-up. Dopamine agonist levodopa equivalent daily dose over 160 mg was significantly associated with impulse control disorders with a positive predictive value of 92.5% (95% confidence interval 79.6%-98.4%). In addition, females had a better prognosis of impulse control disorders compared to males. The development of novel impulse control disorders (no disorder at baseline, disorder at follow-up) was associated with a concurrent increase in depression scores. The results suggest that dopamine agonist dose and gender are associated with the prognosis of impulse control disorders. Symptoms of depression emerge together with novel impulse control disorders in Parkinson's disease. Copyright © 2012 Elsevier Ltd. All rights reserved.

  13. Impulse control disorders in elderly patients.

    Science.gov (United States)

    Tamam, Lut; Bican, Mehtap; Keskin, Necla

    2014-05-01

    There is no epidemiological study on the prevalence of impulse control disorders (ICDs) in the elderly population. The studies on ICDs in elderly patients are limited and some of them are case reports about pathological gambling and kleptomania. The comorbidity of other psychiatric disorders makes diagnosis difficult and has negative effects on both treatment and the prognosis of ICDs. The aim of this study was to determine the prevalence of ICDs among elderly patients and to evaluate the related sociodemographic and clinical features. A total of 76 patients aged 60 and over who have been referred to our outpatient clinics in a one-year period were included in the study. A demographic data form was completed. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) was used to determine axis I psychiatric disorders. The prevalence of ICDs was investigated by using the modified version of the Minnesota Impulse Disorders Interview (MIDI). Impulsivity was measured with the Barratt Impulsiveness Scale Version 11 (BIS-11). The Mini-Mental State Examination (MMSE) test was performed to evaluate the cognitive status of patients and to exclude the diagnosis of dementia. In addition, all patients completed Symptom Check List-90 (SCL-90). The prevalence rate of at least one comorbid ICD in our sample was 17%. When patients with a diagnosis of ICDs not otherwise specified (ICD-NOS) were included, the prevalence rate increased to 22.4%. The most common ICD was intermittent explosive disorder (15.8%), followed by pathological gambling (9.2%). The majority of the sample was men (54%), married (80%), had a high school education (51%), and mid-level socioeconomic status (79%). The only statistically significant difference between the sociodemographic characteristics of patients with or without ICDs was gender. The lifetime prevalence of ICDs was 34.1% in men and 8.6% in women. The prevalence of childhood conduct disorder

  14. [ADH/D and impulsiveness: Prevalence of impulse control disorders and other comorbidities, in 81 adults with attention deficit/hyperactivity disorder (ADH/D)].

    Science.gov (United States)

    Porteret, R; Bouchez, J; Baylé, F J; Varescon, I

    2016-04-01

    Attention deficit hyperactivity disorder (ADH/D) is a neuropsychological developmental disorder characterized by pervasive and impairing symptoms of inattention, hyperactivity, and impulsivity. Whereas it is well known in children, there is still little information about ADH/D in adults, including prevalence. Indeed, there are actually no epidemiological studies in France, despite the considerable impact of this disorder in a patient's professional and affective life. Moreover, ADH/D rarely stays isolated, and many comorbidities often complicate the diagnostic investigation. It is well known that the so-called ADH/D is composed of two main categories of symptoms (Attentional Disorder/Hyperactiviy Disorder), but Impulsiveness also remains a major symptom. The aim of this study was to evaluate not only the prevalence of Impulse Control Disorders (ICD) but also psychological and addictive comorbidities among adult patients with ADH/D. A total of 100 patients from specialized consultations of adult ADH/D were evaluated in this study, but only 81 were included after presenting all the clinical criteria of ADH/D. We used the DSM IV-T-R for ADH/D, the Minnesota Impulsive Disorders Interview a semi-structured clinical interview assessing impulse control disorders (ICD) (compulsive buying, trichotillomania, compulsive sexual behaviour, kleptomania, pyromania and intermittent explosive disorder), and the Mini International Neuropsychiatric Interview in order to evaluate psychiatric and addictive comorbidities. More than 90 % of the patients met the early apparition criteria of ADH/D (before 7years). More than half of the patients presented a mixed type of ADH/D (both inattentive and hyperactive-impulsive forms): 55.6 % vs 44.4 % for the inattentive type. The vast majority of patients showed a complete form (with a total of 6 or more symptoms out of 9, of inattentive and/or impulsive-hyperactivity category): 93.8 % and only 6.2 % presented a sub-syndromic form of ADH/D (with

  15. [Impulse control disorders in borderline and antisocial personality disorder].

    Science.gov (United States)

    Herpertz, S

    2007-01-18

    A borderline personality disorder is associated with highly impulsive acts that cannot be controlled by cognitive inhibition. In a psychopathic/antisocial personality disorder emotional inhibition of hostile acts is lacking. The patient has a high proclivity for risk-seeking, and is incapable of responding appropriately to punishment. In both disorders, the result is (auto)aggressive behavior. The family doctor must refer such patients to a specialist, when there is an acute danger of self-harm or when a grave functional limitation in the areas of work or interpersonal relationship has persisted over a long period of time.

  16. Neurobiologia dos transtornos do controle dos impulsos The neurobiology of impulse control disorders

    Directory of Open Access Journals (Sweden)

    Wendol A Williams

    2008-05-01

    Full Text Available OBJETIVO: Revisar os artigos sobre substratos neurobiológicos dos transtornos do controle dos impulsos. O jogo patológico é o foco central desta revisão na medida em que a maioria dos estudos biológicos dos formalmente classificados como transtornos do controle dos impulsos examinou este transtorno. MÉTODO: Foi feita uma busca no banco de dados Medline de artigos publicados de 1966 até o presente para identificar aqueles relevantes para serem revisados neste artigo. DESFECHOS: Estudos pré-clínicos sugerem que a neuromodulação das monoaminas cerebrais está associada à tomada de decisões impulsivas e aos comportamentos de risco. Os estudos clínicos implicam diversos sistemas de neurotransmissores (serotoninérgico, dopaminérgico, adrenérgico e opióide na fisiopatologia do jogo patológico e de outros transtornos do controle dos impulsos. Estudos de neuroimagem preliminares têm indicado o córtex pré-frontal ventromedial e o estriato ventral como atuantes na fisiopatologia do jogo patológico e de outros transtornos do controle dos impulsos. As contribuições genéticas para o jogo patológico parecem substanciais e os estudos iniciais têm relacionado esse transtorno a polimorfismos alélicos específicos, ainda que os achados de varredura genômica ainda tenham que ser publicados. CONCLUSÃO: Mesmo que tenham sido logrados avanços significativos em nossa compreensão sobre os transtornos do controle dos impulsos, mais pesquisas são necessárias para ampliar o conhecimento existente e traduzir esses achados em avanços clínicos.OBJECTIVE: To review the neurobiological substrates of impulse control disorders. Pathological gambling is a main focus of the review in that most biological studies of the formal impulse control disorders have examined this disorder. METHOD: The medical database Medline from 1966 to present was searched to identify relevant articles that were subsequently reviewed to generate this manuscript

  17. Association between problematic Internet use and impulse control disorders among Iranian university students.

    Science.gov (United States)

    Mazhari, Shahrzad

    2012-05-01

    Previous studies have examined the relationship between problematic Internet use (PIU) with pathological gambling and impulsivity. However, few studies have investigated the association between PIU and other impulse control disorders. This study aimed to assess whether PIU is related to compulsive buying, kleptomania, trichotillomania, intermittent explosive disorder, and pyromania, among a sample of Iranian university students. A cross-sectional study design was used among a random sample of (n=950) university students. Self-reported questionnaires, including demographic, Problematic Internet Use Questionnaire (PIUQ) and Minnesota Impulse Disorders Interview were utilized. The prevalence of PIU was 21.2 percent. Students with diagnosis of either compulsive buying, or intermittent explosive disorder, or pyromania had significantly higher scores on PIUQ compared to the students without the diagnosis. Multivariate regression analyses indicated that in the male gender, the diagnosis of either compulsive buying or intermittent explosive disorder were significant predictors of the risk of the PIU. The results support the proposal that PIU should be considered as a spectrum of impulse control disorder.

  18. Harms associated with taking nalmefene for substance use and impulse control disorders

    DEFF Research Database (Denmark)

    Johansen, Karina Glies Vincents; Tarp, Simon; Astrup, Arne

    2017-01-01

    IMPORTANCE: Nalmefene is a newly approved drug for alcohol use disorder, but the risk of harms has not been evaluated from empirical trial evidence. OBJECTIVE: To assess the harm of nalmefene administered to individuals diagnosed with substance use or impulse control disorders by performing...... only randomised controlled trials with placebo or active controls that administered nalmefene to adult individuals for treating impulse control and/or substance use disorders. Both published and unpublished randomised controlled trials were eligible for inclusion. DATA EXTRACTION AND SYNTHESIS...... a systematic review and meta-analysis of randomised controlled trials. DATA SOURCES: A search was performed in Cochrane Central Register of Controlled Trials (CENTRAL, 2014), MEDLINE via PubMed (1950), EMBASE via Ovid (1974), and Clinicaltrials.gov through December 2014. STUDY SELECTION: This study included...

  19. Impulse control disorders in Parkinson's disease: recent advances.

    Science.gov (United States)

    Voon, Valerie; Mehta, Arpan R; Hallett, Mark

    2011-08-01

    The aim is to review the recent advances in the epidemiology and pathophysiology of impulse control disorders (ICDs) in Parkinson's disease. Large cross-sectional and case-control multicentre studies show that ICDs in Parkinson's disease are common, with a frequency of 13.6%. These behaviours are associated with impaired functioning and with depressive, anxiety and obsessive symptoms, novelty seeking and impulsivity. Behavioural subtypes demonstrate differences in novelty seeking and impulsivity, suggesting pathophysiological differences. Observational and neurophysiological studies point towards a potential mechanistic overlap between behavioural (ICDs) and motor (dyskinesias) dopaminergic sequelae. Converging data suggest dopamine agonists in ICDs appear to enhance learning from rewarding outcomes and impulsive choice. ICD patients also have enhanced risk preference and impaired working memory. Neuroimaging data point towards enhanced bottom-up ventral striatal dopamine release to incentive cues, gambling tasks and reward prediction, and possible inhibition of top-down orbitofrontal influences. Dopamine agonist-related ventral striatal hypoactivity to risk is consistent with impaired risk evaluation. Recent large-scale studies and converging findings are beginning to provide an understanding of mechanisms underlying ICDs in Parkinson's disease, which can guide prevention of these behaviours and optimize therapeutic approaches.

  20. Impulse control disorders and related behaviours (ICD-RBs) in Parkinson's disease patients: Assessment using ?Questionnaire for impulsive-compulsive disorders in Parkinson's disease? (QUIP)

    OpenAIRE

    Sharma, Ashish; Goyal, Vinay; Behari, Madhuri; Srivastva, Achal; Shukla, Garima; Vibha, Deepti

    2015-01-01

    Background: There is limited data on the prevalence of impulse control disorder and related behaviors (ICD-RBs) in Indian patients with Parkinson′s Disease (PD). In the context of potential genetic and environmental factors affecting the expression of ICD-RBs, studying other multiethnic populations may bring in-sights into the mechanisms of these disorders. Objectives: To ascertain point prevalence estimate of ICD-RBs in Indian PD patients, using the validated “Questionnaire for Impulsive-Com...

  1. Parkinson's disease treatment may cause impulse-control disorder via dopamine D3 receptors.

    Science.gov (United States)

    Seeman, Philip

    2015-04-01

    In treating Parkinson's disease with dopaminergic agonists, such as pramipexole, ropinirole, pergolide, rotigotine, apomorphine, or bromocriptine, it has been observed that a significant number of patients develop impulse-control disorders, such as compulsive shopping, pathological gambling, or hypersexuality. Because the dopamine agonists have high affinities for the dopamine D2 and D3 receptors, the drug dissociation constants of these drugs at the functional high-affinity states of these receptors, namely D2High and D3High, were compared. The data show that, compared to the other dopamine agonist drugs, pramipexole has a relatively high selectivity for the dopamine D3 receptor, as compared to D2, suggesting that the D3 receptor may be a primary target for pramipexole. There is a trend showing that the proportion of impulse-control disorders is related to the selectivity for D3 receptors over D2 receptors, with pramipexole having the highest association with, or frequency of, impulse-control disorders. While the number of studies are limited, the proportion of patients with impulse-control disorder in Parkinson patients treated with an add-on agonist were 32% for pramipexole, 25% for ropinirole, 16% for pergolide, 22% for rotigotine, 10% for apomorphine, and 6.8% for bromocriptine. Clinically, temporary replacement of pramipexole by bromocriptine may provide relief or reversal of the impulsive behavior associated with selective D3 stimulation by either pramipexole or ropinirole, while maintaining D2 stimulation needed for the anti-Parkinson action. © 2015 Wiley Periodicals, Inc.

  2. Trait Impulsivity and Anhedonia: Two Gateways for the Development of Impulse Control Disorders in Parkinson's Disease?

    Science.gov (United States)

    Houeto, Jean-Luc; Magnard, Robin; Dalley, Jeffrey W; Belin, David; Carnicella, Sebastien

    2016-01-01

    Apathy and impulsivity are two major comorbid syndromes of Parkinson's disease (PD) that may represent two extremes of a behavioral spectrum modulated by dopamine-dependent processes. PD is characterized by a progressive loss of dopaminergic neurons in the substantia nigra pars compacta to which are attributed the cardinal motor symptoms of the disorder. Dopamine replacement therapy (DRT), used widely to treat these motor symptoms, is often associated with deficits in hedonic processing and motivation, including apathy and depression, as well as impulse control disorders (ICDs). ICDs comprise pathological gambling, hypersexuality, compulsive shopping, binge eating, compulsive overuse of dopaminergic medication, and punding. More frequently observed in males with early onset PD, ICDs are associated not only with comorbid affective symptoms, such as depression and anxiety, but also with behavioral traits, such as novelty seeking and impulsivity, as well as with personal or familial history of alcohol use. This constellation of associated risk factors highlights the importance of inter-individual differences in the vulnerability to develop comorbid psychiatric disorders in PD patients. Additionally, withdrawal from DRT in patients with ICDs frequently unmasks a severe apathetic state, suggesting that apathy and ICDs may be caused by overlapping neurobiological mechanisms within the cortico-striato-thalamo-cortical networks. We suggest that altered hedonic and impulse control processes represent distinct prodromal substrates for the development of these psychiatric symptoms, the etiopathogenic mechanisms of which remain unknown. Specifically, we argue that deficits in hedonic and motivational states and impulse control are mediated by overlapping, yet dissociable, neural mechanisms that differentially interact with DRT to promote the emergence of ICDs in vulnerable individuals. Thus, we provide a novel heuristic framework for basic and clinical research to better

  3. Trait impulsivity and anhedonia: two gateways for the development of impulse control disorders in Parkinson's disease?

    Directory of Open Access Journals (Sweden)

    Jean-Luc eHoueto

    2016-05-01

    Full Text Available Apathy and impulsivity are two major comorbid syndromes of Parkinson’s disease (PD that may represent two extremes of a behavioral spectrum modulated by dopamine-dependent processes. PD is characterized by a progressive loss of dopaminergic neurons in the substantia nigra pars compacta to which are attributed the cardinal motor symptoms of the disorder. Dopamine replacement therapy (DRT, used widely to treat these motor symptoms, is often associated with deficits in hedonic processing and motivation, including apathy and depression, as well as impulse control disorders (ICDs. ICDs comprise pathological gambling, hypersexuality, compulsive shopping, binge eating, compulsive overuse of dopaminergic medication, and punding. More frequently observed in males with early onset PD, ICDs are associated not only with co-morbid affective symptoms such as depression and anxiety, but also with behavioral traits such as novelty seeking and impulsivity, as well as with personal or familial history of alcohol use. This constellation of associated risk factors highlights the importance of inter-individual differences in the vulnerability to develop comorbid psychiatric disorders in PD patients. Additionally, withdrawal from DRT in patients with ICDs frequently unmasks a severe apathetic state, suggesting that apathy and ICDs may be caused by overlapping neurobiological mechanisms within the cortico-striato-thalamo-cortical networks. We suggest that altered hedonic and impulse control processes represent distinct prodromal substrates for the development of these psychiatric symptoms, the etiopathogenic mechanisms of which remain unknown. Specifically, we argue that deficits in hedonic and motivational states and impulse control are mediated by overlapping, yet dissociable, neural mechanisms that differentially interact with DRT to promote the emergence of ICDs in vulnerable individuals. We thus provide a novel heuristic framework for basic and clinical

  4. Impulsivity and Cluster B Personality Disorders.

    Science.gov (United States)

    Turner, Daniel; Sebastian, Alexandra; Tüscher, Oliver

    2017-03-01

    Impulsivity is a multifaceted construct and an important personality trait in various mental health conditions. Among personality disorders (PDs), especially cluster B PDs are affected. The aims of this review are to summarize the relevant findings of the past 3 years concerning impulsivity in cluster B PDs and to identify those subcomponents of self-reported impulsivity and experimentally measured impulse control that are most affected in these disorders. All studies referred to antisocial (ASPD) or borderline PD (BPD), and none were found for narcissistic or histrionic PD. In ASPD as well as BPD, self-report scales primarily revealed heightened impulsivity compared to healthy controls. In experimental tasks, ASPD patients showed impairments in response inhibition, while fewer deficits were found in delay discounting. BPD patients showed specific impairments in delay discounting and proactive interference, while response inhibition was less affected. However, after inducing high levels of stress, deficits in response inhibition could also be observed in BPD patients. Furthermore, negative affect led to altered brain activation patterns in BPD patients during impulse control tasks, but no behavioral impairments were found. As proposed by the DSM-5 alternative model for personality disorders, heightened impulsivity is a core personality trait in BPD and ASPD, which is in line with current research findings. However, different components of experimentally measured impulse control are affected in BPD and ASPD, and impulsivity occurring in negative emotional states or increased distress seems to be specific for BPD. Future research could be focused on measures that assess impulsive behaviors on a momentary basis as this is a promising approach especially for further ecological validation and transfer into clinical practice.

  5. A single-center, cross-sectional prevalence study of impulse control disorders in Parkinson disease: association with dopaminergic drugs.

    Science.gov (United States)

    Poletti, Michele; Logi, Chiara; Lucetti, Claudio; Del Dotto, Paolo; Baldacci, Filippo; Vergallo, Andrea; Ulivi, Martina; Del Sarto, Simone; Rossi, Giuseppe; Ceravolo, Roberto; Bonuccelli, Ubaldo

    2013-10-01

    The current study aimed at establishing the prevalence of impulse control disorders (ICDs) in patients with Parkinson disease (PD) and their association with demographic, drug-related, and disease-related characteristics. We performed a single-center cross-sectional study of 805 PD patients. Impulse control disorders were investigated with the Questionnaire for Impulsive Compulsive Disorders in Parkinson's Disease; also comorbid neuropsychiatric complications (dementia, delusions, visual hallucinations) were investigated with clinical interviews and ad hoc instruments (Parkinson Psychosis Questionnaire and Neuropsychiatry Inventory). Impulse control disorders were identified in 65 patients (prevalence, 8.1%), with pathological gambling and hypersexuality the most frequent. Impulse control disorders were present in 57 of 593 cognitively preserved patients (prevalence, 9.6%) and in 8 of 212 demented patients (prevalence, 3.8%). Impulse control disorders were significantly associated with dopamine agonists (odds ratio [OR], 5.50; 95% confidence interval [CI], 2.60-12.46; P Impulse control disorders frequency was similar for pramipexole and ropinirole (16.6% vs 12.5%; OR, 1.45; 95% CI, 0.79-2.74; P = 0.227). Additional variables associated with ICDs were male sex and younger age. These findings suggested that dopaminergic treatments in PD are associated with increased odds of having an ICD, but also other demographic and clinical variables are associated with ICDs, suggesting the multifactorial nature of the ICD phenomenon in PD.

  6. [A case of compulsive buying--impulse control disorder or dependence disorder?].

    Science.gov (United States)

    Croissant, Bernhard; Klein, Oliver; Löber, Sabine; Mann, Karl

    2009-05-01

    It is unclear what disease entity causes compulsive buying. In ICD-10 and DSM-IV, compulsive buying is classified as "Impulse control disorder--not otherwise classified". Some publications interpret compulsive buying rather as a dependence disorder. We present the case of a male patient with compulsive buying syndrome. We discuss the close relationship to dependence disorders. The patient showed symptoms which would normally be associated with a dependence disorder. On the basis of a wider understanding of the dependency concept, as it is currently being discussed, we believe that the patient has shown a typical buying behavior that has presumably activated a reward loop similar to that of a substance dependency.

  7. Epidemiologic and clinical updates on impulse control disorders: a critical review

    Science.gov (United States)

    Altamura, A. Carlo; Allen, Andrea; Marazziti, Donatella; Hollander, Eric

    2006-01-01

    The article reviews the current knowledge about the impulse control disorders (ICDs) with specific emphasis on epidemiological and pharmacological advances. In addition to the traditional ICDs present in the DSM-IV—pathological gambling, trichotillomania, kleptomania, pyromania and intermittent explosive disorder—a brief description of the new proposed ICDs—compulsive–impulsive (C–I) Internet usage disorder, C–I sexual behaviors, C–I skin picking and C–I shopping—is provided. Specifically, the article summarizes the phenomenology, epidemiology and comorbidity of the ICDs. Particular attention is paid to the relationship between ICDs and obsessive–compulsive disorder (OCD). Finally, current pharmacological options for treating ICDs are presented and discussed. PMID:16960655

  8. Impulse control disorders in Parkinson's disease: crossroads between neurology, psychiatry and neuroscience.

    Science.gov (United States)

    Bugalho, Paulo; Oliveira-Maia, Albino J

    2013-01-01

    Non-motor symptoms contribute significantly to Parkinson's disease (PD) related disability. Impulse control disorders (ICDs) have been recently added to the behavioural spectrum of PD-related non-motor symptoms. Such behaviours are characterized by an inappropriate drive to conduct repetitive behaviours that are usually socially inadequate or result in harmful consequences. Parkinson disease impulse control disorders (PD-ICDs) have raised significant interest in the scientific and medical community, not only because of their incapacitating nature, but also because they may represent a valid model of ICDs beyond PD and a means to study the physiology of drive, impulse control and compulsive actions in the normal brain. In this review, we discuss some unresolved issues regarding PD-ICDs, including the association with psychiatric co-morbidities such as obsessive-compulsive disorder and with dopamine related side effects, such as hallucinations and dyskinesias; the relationship with executive cognitive dysfunction; and the neural underpinnings of ICDs in PD. We also discuss the contribution of neuroscience studies based on animal-models towards a mechanistic explanation of the development of PD-ICDs, specifically regarding corticostriatal control of goal directed and habitual actions.

  9. Clinical spectrum of impulse control disorders in Parkinson's disease.

    Science.gov (United States)

    Weintraub, Daniel; David, Anthony S; Evans, Andrew H; Grant, Jon E; Stacy, Mark

    2015-02-01

    Impulse control disorders (ICDs), including compulsive gambling, buying, sexual behavior, and eating, are a serious and increasingly recognized psychiatric complication in Parkinson's disease (PD). Other impulsive-compulsive behaviors (ICBs) have been described in PD, including punding (stereotyped, repetitive, purposeless behaviors) and dopamine dysregulation syndrome (DDS; compulsive PD medication overuse). ICDs have been most closely related to the use of dopamine agonists (DAs), perhaps more so at higher doses; in contrast, DDS is primarily associated with shorter-acting, higher-potency dopaminergic medications, such as apomorphine and levodopa. Possible risk factors for ICDs include male sex, younger age and younger age at PD onset, a pre-PD history of ICDs, and a personal or family history of substance abuse, bipolar disorder, or gambling problems. Given the paucity of treatment options and potentially serious consequences, it is critical for PD patients to be monitored closely for development of ICDs as part of routine clinical care. © 2014 International Parkinson and Movement Disorder Society.

  10. The emergence of devastating impulse control disorders during dopamine agonist therapy of the restless legs syndrome.

    Science.gov (United States)

    Dang, Dien; Cunnington, David; Swieca, John

    2011-01-01

    The Restless Legs Syndrome is a common sensorimotor disorder, typically amenable to treatment with dopamine agonist therapy. Dopamine agonists have been associated with emergent impulse control disorders (ICDs) when used in patients with Parkinson disease, and ICDs have now been reported in individuals with RLS on dopamine agonist therapy. Our aim was to characterize cases of emergent ICDs in Australian patients with focus on the dopamine agonists implicated and the social significance of ICDs. A series of RLS patients on dopamine agonist therapy were identified with ICDs over a 2-year period. Additional cases of ICDs were found using a mailout questionnaire designed to capture those with high impulsivity. These patients were assessed using the Barratt Impulsiveness Scale, Version 11, and a modified Minnesota Impulse Disorders Interview. Case records and medication schedules were evaluated. Twelve cases of patients with de novo ICDs were found with a range of impulsive behaviors including pathological gambling, kleptomania, compulsive shopping, and hypersexuality. Criminality, suicidality, and marital discord also were featured. These occurred over a wide range of latencies and l-dopa exposures. This group of Australian RLS patients with ICDs display high levels of impulsivity and is the first to use the BIS-11 questionnaire in this setting. Impulse control disorders can occur over a wide range of dopamine agonist therapy types and dose exposures. Impulse control disorder tendencies may persist, despite withdrawal of dopamine agonists. The emergence of ICDs needs careful consideration in light of their potentially devastating financial, social, and marital consequences.

  11. Impulse control and related disorders in Mexican Parkinson's disease patients.

    Science.gov (United States)

    Rodríguez-Violante, Mayela; González-Latapi, Paulina; Cervantes-Arriaga, Amin; Camacho-Ordoñez, Azyadeh; Weintraub, Daniel

    2014-08-01

    Impulse control disorders (ICDs) are a relatively recent addition to the behavioral spectrum of PD-related non-motor symptoms. Social and economic factors may play a role on the ICD phenotype of PD patients. The aim of this study is to determine the prevalence and characterize the clinical profile of ICDs in a sample of low-income, low-education PD patients with no social security benefits from a Latin American country. We included 300 consecutive PD patients and 150 control subjects. The presence of ICD and related disorders was assessed using a structured interview. After the interview and neurological evaluation were concluded, all subjects completed the Questionnaire for Impulsive-compulsive Disorders in Parkinson's Disease-Rating Scale (QUIP-RS). Regarding ICDs and related disorders (hobbyism-punding), 25.6% (n = 77) of patients in the PD group and 16.6% (n = 25) in the control group fulfilled criteria for at least one ICD or related disorder (p = 0.032). There was a statistically significant difference in the QUIP-RS mean score between PD and control subjects (5.6 ± 9.7 and 2.7 ± 4.21, p = 0.001). The most common ICD was compulsive eating for both PD (8.6%) and control (2.6%) groups. The results of this study confirm that for this population, symptoms of an ICD are significantly more frequent in PD subjects than in control subjects. Nevertheless, socioeconomic differences may contribute to a lower overall frequency and distinct pattern of ICDs in PD patients compared with what has been reported in other countries. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Impulse Control Disorders in Parkinson’s Disease: Crossroads between Neurology, Psychiatry and Neuroscience

    Directory of Open Access Journals (Sweden)

    Paulo Bugalho

    2013-01-01

    Full Text Available Non-motor symptoms contribute significantly to Parkinson’s disease (PD related disability. Impulse control disorders (ICDs have been recently added to the behavioural spectrum of PD-related non-motor symptoms. Such behaviours are characterized by an inappropriate drive to conduct repetitive behaviours that are usually socially inadequate or result in harmful consequences. Parkinson disease impulse control disorders (PD-ICDs have raised significant interest in the scientific and medical community, not only because of their incapacitating nature, but also because they may represent a valid model of ICDs beyond PD and a means to study the physiology of drive, impulse control and compulsive actions in the normal brain. In this review, we discuss some unresolved issues regarding PD-ICDs, including the association with psychiatric co-morbidities such as obsessive-compulsive disorder and with dopamine related side effects, such as hallucinations and dyskinesias; the relationship with executive cognitive dysfunction; and the neural underpinnings of ICDs in PD. We also discuss the contribution of neuroscience studies based on animal-models towards a mechanistic explanation of the development of PD-ICDs, specifically regarding corticostriatal control of goal directed and habitual actions.

  13. Prevalence and pharmacological factors associated with impulse-control disorder symptoms in patients with Parkinson disease.

    Science.gov (United States)

    Perez-Lloret, Santiago; Rey, María Verónica; Fabre, Nelly; Ory, Fabienne; Spampinato, Umberto; Brefel-Courbon, Christine; Montastruc, Jean-Louis; Rascol, Olivier

    2012-01-01

    Impulse-control disorders (ICDs) occur in patients with Parkinson disease (PD), especially in younger patients on dopamine therapies. To assess the prevalence of ICD symptoms and its pharmacological correlations in a sample of French patients with PD and without PD (poststroke). Outpatients with PD and without PD (poststroke) were screened for compulsive behaviors related to hypersexuality, compulsive shopping, pathological gambling, or compulsive eating by means of the Questionnaire for Impulse-Control Disorders--short version. Full medical history and Unified Parkinson's Disease Rating Scale scores were also recorded. Dose of dopamine agonists were converted to defined daily doses (DDDs), according to the World Health Organization Anatomical Therapeutic Chemical classification system classification system. Two hundred three patients with PD and 52 patients without PD were recruited (mean ± SD age, 67 ± 1 vs 69 ± 2, P= 0.4; males: 62% vs 55% P= 0.2). Symptoms of ICDs were reported by 0% of poststroke patients and 25% of the patients with PD (P Impulse-control disorder symptoms were more frequent in the patients with PD than in the poststroke patients with PD. Impulse-control disorder symptoms were related to younger age and exposure to monoaminooxidase-B inhibitors, and showed a nonlinear dose-response relationship with dopamine agonists.

  14. Impulsivity, Mental Disorder, and Suicide in Rural China.

    Science.gov (United States)

    Lin, Lin; Zhang, Jie

    2017-01-02

    The purpose of this study was to investigate the relationship among impulsivity, mental disorder, and suicide with a sample of rural young Chinese. Subjects were 392 consecutively recruited male and female suicides aged 15-34 years and 416 community male and female controls of the same age range sampled in rural China. The case-control data were obtained using psychological autopsy with structured and semi-structured instruments. Dysfunctional impulsivity was a significant risk factor regardless of mental disorder in rural China. Dysfunctional impulsivity is a potential area for further study of suicidal behavior. The suicide prevention efforts in rural China may address impulsivity.

  15. Reduced dopamine transporter binding predates impulse control disorders in Parkinson's disease

    NARCIS (Netherlands)

    Vriend, Chris; Nordbeck, Anna H; Booij, Jan; van der Werf, Ysbrand D; Pattij, Tommy; Voorn, Pieter; Raijmakers, Pieter; Foncke, Elisabeth M J; van de Giessen, Elsmarieke; Berendse, Henk W; van den Heuvel, Odile A

    Impulse control disorders (ICD) are relatively common in Parkinson's disease (PD) and generally are regarded as adverse effects of dopamine replacement therapy, although certain demographic and clinical risk factors are also involved. Previous single-photon emission computed tomography (SPECT)

  16. Reduced Dopamine Transporter Binding Predates Impulse Control Disorders in Parkinson's Disease

    NARCIS (Netherlands)

    Vriend, C.; Nordbeck, A.H.; Booij, J.; van der Werf, Y.D.; Pattij, T.; Voorn, P.; Raijmakers, P.; Foncke, E.M.J.; van der Giessen, E.; Berendse, H.W.; van den Heuvel, O.A.

    2014-01-01

    Impulse control disorders (ICD) are relatively common in Parkinson's disease (PD) and generally are regarded as adverse effects of dopamine replacement therapy, although certain demographic and clinical risk factors are also involved. Previous single-photon emission computed tomography (SPECT)

  17. Obsessive-compulsive disorder, impulse control disorders and drug addiction: common features and potential treatments.

    Science.gov (United States)

    Fontenelle, Leonardo F; Oostermeijer, Sanne; Harrison, Ben J; Pantelis, Christos; Yücel, Murat

    2011-05-07

    The basic concepts underlying compulsive, impulsive and addictive behaviours overlap, which may help explain why laymen use these expressions interchangeably. Although there has been a large research effort to better characterize and disentangle these behaviours, clinicians and scientists are still unable to clearly differentiate them. Accordingly, obsessive-compulsive disorder (OCD), impulse control disorders (ICD) and substance-related disorders (SUD) overlap on different levels, including phenomenology, co-morbidity, neurocircuitry, neurocognition, neurochemistry and family history. In this review we summarize these issues with particular emphasis on the role of the opioid system in the pathophysiology and treatment of OCD, ICD and SUD. We postulate that with progression and chronicity of OCD, the proportion of the OCD-related behaviours (e.g. checking, washing, ordering and hoarding, among others) that are driven by impulsive 'rash' processes increase as involvement of more ventral striatal circuits becomes prominent. In contrast, as SUD and ICD progress, the proportion of the SUD- and ICD-related behaviours that are driven by compulsive 'habitual' processes increase as involvement of more dorsal striatal circuits become prominent. We are not arguing that, with time, ICD becomes OCD or vice versa. Instead, we are proposing that these disorders may acquire qualities of the other with time. In other words, while patients with ICD/SUD may develop 'compulsive impulsions', patients with OCD may exhibit 'impulsive compulsions'. There are many potential implications of our model. Theoretically, OCD patients exhibiting impulsive or addictive features could be managed with drugs that address the quality of the underlying drives and the involvement of neural systems. For example, agents for the reduction or prevention of relapse of addiction (e.g. heavy drinking), which modulate the cortico-mesolimbic dopamine system through the opioid (e.g. buprenorphine and naltrexone

  18. Past smoking and current dopamine agonist use show an independent and dose-dependent association with impulse control disorders in Parkinson's disease.

    Science.gov (United States)

    Valença, Guilherme T; Glass, Philip G; Negreiros, Nadja N; Duarte, Meirelayne B; Ventura, Lais M G B; Mueller, Mila; Oliveira-Filho, Jamary

    2013-07-01

    Previous studies have described the association between dopamine replacement therapy in Parkinson's disease and impulse control disorders. A case-control study was performed to establish the prevalence of four of these behaviors in Brazilian patients with Parkinson's disease on stable dopamine replacement therapy and the possible associated risk factors. We investigated 152 patients and 212 healthy controls for pathological gambling, compulsive sexual behavior and compulsive buying and eating. Overall, patients had more impulsive control disorders than controls (18.4% vs. 4.2%, P Impulse control disorders were more common in younger patients (P = 0.008) and in those taking dopamine agonist (P impulse control disorders were history of smoking (odds ratio = 1.059 for each year of smoking, P = 0.010) and current use of pramipexole (odds ratio = 2.551 for each increase in 1 mg, P impulse control disorders in a dose-dependent manner. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Impulse control disorders in psychiatric inpatients.

    Science.gov (United States)

    Müller, Astrid; Rein, Katharina; Kollei, Ines; Jacobi, Andrea; Rotter, Andrea; Schütz, Patricia; Hillemacher, Thomas; de Zwaan, Martina

    2011-08-15

    The aim of this study was to examine the prevalence of impulse control disorders (ICDs) in a European psychiatric inpatient sample. Two hundred thirty four consecutive psychiatric inpatients (62% female) were examined using a module of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV) that has been developed for ICDs (SCID-ICD). In addition to intermittent explosive disorder, pyromania, kleptomania, pathological gambling, and trichotillomania, the proposed ICDs not otherwise specified were assessed, including compulsive buying, nonparaphilic compulsive sexual behavior, pathological internet use, and pathological skin picking. Based on the SCID-ICD, a lifetime ICD rate of 23.5% and a current ICD rate of 18.8% were found. The most frequent ICDs were pathological skin picking (lifetime 7.3%, current 6.8%), compulsive buying (lifetime 6.8%, current 6.0%), and intermittent explosive disorder (lifetime 5.6%, current 3.4%). In contrast, referring to admission diagnoses taken from patients' charts only 3.8% of the inpatients were diagnosed with any current ICD. Individuals with comorbid ICD were significantly younger and had more admission diagnoses other than ICD. The results suggest high rates of ICDs among psychiatric inpatients that remain to be under-diagnosed in clinical routine. 2011 Elsevier Ireland Ltd. All rights reserved.

  20. Involvement of the subthalamic nucleus in impulse control disorders associated with Parkinson's disease.

    Science.gov (United States)

    Rodriguez-Oroz, Maria C; López-Azcárate, Jon; Garcia-Garcia, David; Alegre, Manuel; Toledo, Jon; Valencia, Miguel; Guridi, Jorge; Artieda, Julio; Obeso, Jose A

    2011-01-01

    Behavioural abnormalities such as impulse control disorders may develop when patients with Parkinson's disease receive dopaminergic therapy, although they can be controlled by deep brain stimulation of the subthalamic nucleus. We have recorded local field potentials in the subthalamic nucleus of 28 patients with surgically implanted subthalamic electrodes. According to the predominant clinical features of each patient, their Parkinson's disease was associated with impulse control disorders (n = 10), dyskinesias (n = 9) or no dopaminergic mediated motor or behavioural complications (n = 9). Recordings were obtained during the OFF and ON dopaminergic states and the power spectrum of the subthalamic activity as well as the subthalamocortical coherence were analysed using Fourier transform-based techniques. The position of each electrode contact was determined in the postoperative magnetic resonance image to define the topography of the oscillatory activity recorded in each patient. In the OFF state, the three groups of patients had similar oscillatory activity. By contrast, in the ON state, the patients with impulse control disorders displayed theta-alpha (4-10 Hz) activity (mean peak: 6.71 Hz) that was generated 2-8 mm below the intercommissural line. Similarly, the patients with dyskinesia showed theta-alpha activity that peaked at a higher frequency (mean: 8.38 Hz) and was generated 0-2 mm below the intercommissural line. No such activity was detected in patients that displayed no dopaminergic side effects. Cortico-subthalamic coherence was more frequent in the impulsive patients in the 4-7.5 Hz range in scalp electrodes placed on the frontal regions anterior to the primary motor cortex, while in patients with dyskinesia it was in the 7.5-10 Hz range in the leads overlying the primary motor and supplementary motor area. Thus, dopaminergic side effects in Parkinson's disease are associated with oscillatory activity in the theta-alpha band, but at different

  1. Interactions between bipolar disorder and antisocial personality disorder in trait impulsivity and severity of illness.

    Science.gov (United States)

    Swann, A C; Lijffijt, M; Lane, S D; Steinberg, J L; Moeller, F G

    2010-06-01

    We investigated trait impulsivity in bipolar disorder and antisocial personality disorder (ASPD) with respect to severity and course of illness. 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. 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. 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.

  2. Impulsive-compulsive buying disorder: clinical overview.

    Science.gov (United States)

    Dell'Osso, Bernardo; Allen, Andrea; Altamura, A Carlo; Buoli, Massimiliano; Hollander, Eric

    2008-04-01

    Impulsive-compulsive buying disorder (ICBD) is an impulse control disorder not otherwise specified (ICD-NOS) characterized by impulsive drives and compulsive behaviours (buying unneeded things), personal distress, impaired social and vocational functioning and financial problems. Despite being described in the 19th century, serious attention to ICBD began only in the last decade with the first epidemiological and pharmacological investigation. Biological, social and psychological factors contribute to the aetiology of ICBD. Cognitive-behavioural therapy and selective serotonin re-uptake inhibitors are currently considered the more effective interventions in the treatment of ICBD. The present review aims to provide a broad overview of the epidemiology, aetiology, phenomenology and treatment options of ICBD.

  3. Is impulsivity a common trait in bipolar and unipolar disorders?

    Science.gov (United States)

    Henna, Elaine; Hatch, John P; Nicoletti, Mark; Swann, Alan C; Zunta-Soares, Giovana; Soares, Jair C

    2013-03-01

    Impulsivity is increased in bipolar and unipolar disorders during episodes and is associated with substance abuse disorders and suicide risk. Impulsivity between episodes predisposes to relapses and poor therapeutic compliance. However, there is little information about impulsivity during euthymia in mood disorders. We sought to investigate trait impulsivity in euthymic bipolar and unipolar disorder patients, comparing them to healthy individuals and unaffected relatives of bipolar disorder patients.   Impulsivity was evaluated by the Barratt Impulsiveness Scale (BIS-11A) in 54 bipolar disorder patients, 25 unipolar disorder patients, 136 healthy volunteers, and 14 unaffected relatives. The BIS-11A mean scores for all four groups were compared through the Games-Howell test for all possible pairwise combinations. Additionally, we compared impulsivity in bipolar and unipolar disorder patients with and without a history of suicide attempt and substance abuse disorder.   Bipolar and unipolar disorder patients scored significantly higher than the healthy controls and unaffected relatives on all measures of the BIS-11A except for attentional impulsivity. On the attentional impulsivity measures there were no differences among the unaffected relatives and the bipolar and unipolar disorder groups, but all three of these groups scored higher than the healthy participant group. There was no difference in impulsivity between bipolar and unipolar disorder subjects with and without suicide attempt. However, impulsivity was higher among bipolar and unipolar disorder subjects with past substance use disorder compared to patients without such a history.   Questionnaire-measured impulsivity appears to be relatively independent of mood state in bipolar and unipolar disorder patients; it remains elevated in euthymia and is higher in individuals with past substance abuse. Elevated attentional and lower non-planning impulsivity in unaffected relatives of bipolar disorder

  4. Suicidality in Bipolar Disorder: The Role of Emotion-Triggered Impulsivity.

    Science.gov (United States)

    Johnson, Sheri L; Carver, Charles S; Tharp, Jordan A

    2017-04-01

    A growing body of research suggests that impulsive responses to emotion more robustly predict suicidality than do other forms of impulsivity. This issue has not yet been examined within bipolar disorder, however. Participants diagnosed with bipolar I disorder (n = 133) and control participants (n = 110) diagnosed with no mood or psychotic disorder completed self-report measures of emotion-triggered impulsivity (Negative and Positive Urgency Scales) and interviews concerning lifetime suicidality. Analyses examined the effects of emotion-triggered impulsivity alone and in combination with gender, age of onset, depression severity, comorbid anxiety, comorbid substance use, and medication. A history of suicide ideation and attempts, as well as self-harm, were significantly more common in the bipolar disorder group compared with the control group. Impulsive responses to positive emotions related to suicide ideation, attempts, and self-harm within the bipolar group. Findings extend research on the importance of emotion-triggered impulsivity to a broad range of key outcomes within bipolar disorder. The discussion focuses on limitations and potential clinical implications. © 2016 The American Association of Suicidology.

  5. A CASE OF SELF-INDUCED ACUTE HYDROPS IN A PATIENT WITH IMPULSE CONTROL DISORDER ASSOCIATED WITH COMPULSIVE EYE TRAUMA

    OpenAIRE

    Bindu Madhavi; Soumya

    2016-01-01

    PURPOSE To describe acute hydrops in a patient with impulse control disorder (not otherwise specified) secondary to self-induced repetitive eye trauma. METHODS A 22-year-old male patient was referred from a psychiatrist with a diagnosis of impulse control disorder not otherwise specified (compulsive impulse self-mutilating behaviour) for opacity and watering of both eyes (left eye more than right eye). Left eye showed features of acute hydrops with Descemet’s tear and rig...

  6. Pet killing as a manifestation of impulse control disorder secondary to pramipexol.

    Science.gov (United States)

    Micheli, Federico; Pellene, Alejandro; Arcushin, Daniela; Calzinari, Aldo; Farret, Michel Sáenz

    2015-01-01

    Impulse control disorders are frequent in Parkinson disease and are commonly associated with dopamine agonists intake. Typical manifestations include punding, hypersexuality, pathological gambling, and other compulsive behaviors. Symptoms often promptly disappear when dopamine agonists are discontinued, but if the origin is misinterpreted, symptoms may become a problem. We here report the case of a patient with juvenile Parkinson disease treated with 4.5 mg/d of pramipexol, who developed the need to adopt cats. He adopted almost 50 of them, but after he adopted them, he felt the need to kill them. The case became well known, and he became depressed and isolated. He was admitted to a psychiatric hospital and thought that he was a psychotic. However, when pramipexol was replaced by levodopa, the symptoms disappeared. This case illustrates the wide range of manifestations of impulse control disorders and warrants the inclusion of violent behaviors among them.

  7. Impulse control disorders and related behaviours (ICD-RBs) in Parkinson's disease patients: Assessment using "Questionnaire for impulsive-compulsive disorders in Parkinson's disease" (QUIP).

    Science.gov (United States)

    Sharma, Ashish; Goyal, Vinay; Behari, Madhuri; Srivastva, Achal; Shukla, Garima; Vibha, Deepti

    2015-01-01

    There is limited data on the prevalence of impulse control disorder and related behaviors (ICD-RBs) in Indian patients with Parkinson's Disease (PD). In the context of potential genetic and environmental factors affecting the expression of ICD-RBs, studying other multiethnic populations may bring in-sights into the mechanisms of these disorders. To ascertain point prevalence estimate of ICD-RBs in Indian PD patients, using the validated "Questionnaire for Impulsive-Compulsive Disorders in Parkinson's disease (QUIP)" and to examine their association with Dopamine replacement therapy (DRT). This was a hospital based observational cross-sectional study. After taking informed consent, patients and their informants (spouse, or primary caregiver) were made to complete the QUIP, and were instructed to answer questions based on behaviors that occurred anytime during PD that lasted at least four consecutive weeks. Total of 299 patients participated in the study. At least one ICD-RB was present in 128 (42.8%), at least one Impulse control disorder (ICD) was present in 74 (24.75%) and at least one Impulse control related compulsive behaviour (ICRB) was present in 93 (31.1%) patients. Punding was the most frequent (12.4%) followed by hyper sexuality (11.04%), compulsive hobbyism (9.4%), compulsive shopping (8.4%), compulsive medication use (7.7%), compulsive eating (5.35%), walkabout (4%) and pathological gambling (3.3%). ≥ 2 ICD-RBs were observed in 15.7% of patients. After multivariate analysis, younger age of onset, being unmarried were specifically associated with presence of ICD. Longer disease duration was specifically associated with presence of ICRB. Whereas smoking and higher dopamine levodopa equivalent daily doses (DA LEDD) were associated with both presence of ICD and ICRB. Higher LD LEDD was specifically associated with presence of ICD-RB. Our study revealed a relatively higher frequency of ICD-RBs, probably because of the use of screening instrument and because

  8. A CASE OF SELF-INDUCED ACUTE HYDROPS IN A PATIENT WITH IMPULSE CONTROL DISORDER ASSOCIATED WITH COMPULSIVE EYE TRAUMA

    Directory of Open Access Journals (Sweden)

    Bindu Madhavi

    2016-03-01

    Full Text Available PURPOSE To describe acute hydrops in a patient with impulse control disorder (not otherwise specified secondary to self-induced repetitive eye trauma. METHODS A 22-year-old male patient was referred from a psychiatrist with a diagnosis of impulse control disorder not otherwise specified (compulsive impulse self-mutilating behaviour for opacity and watering of both eyes (left eye more than right eye. Left eye showed features of acute hydrops with Descemet’s tear and right eye showed corneal opacity with Descemet’s tear (status post hydrops. RESULT The patient was prescribed cycloplegics, hypertonic saline for left eye and was advised against scratching the eye and was given protective goggles and was told for close followup in conjunction with psychiatric management. CONCLUSION Impulse control disorders are relatively common psychiatric conditions, yet are poorly understood by clinicians, patients suffering from the disorder and public. And hence identification of this disorder and close observation of patient allows for avoiding complications such as progression of hydrops, perforation and infection.

  9. Molecular imaging and neural networks in impulse control disorders in Parkinson's disease.

    Science.gov (United States)

    Aracil-Bolaños, I; Strafella, A P

    2016-01-01

    Impulse control disorders (ICDs) may arise in Parkinson's disease (PD) in relation to the use of dopamine agonists (DA). A dysfunction of reward circuits is considered the main underlying mechanism. Neuroimaging has been largely used in this setting to understand the structure of the reward system and its abnormalities brought by exogenous stimulation in PD. Dopaminergic changes, such as increased dopamine release, reduced dopamine transporter activity and other changes, have been shown to be a consistent feature of ICDs in PD. Beyond the striatum, alterations of prefrontal cortical function may also impact an individuals' propensity for impulsivity. Neuroimaging is advancing our knowledge of the mechanisms involved in the development of these behavioral addictions. An increased understanding of these disorders may lead to the discovery of new therapeutic targets, or the identification of risk factors for the development of these disorders. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Impulse control disorders in Parkinson disease: a cross-sectional study of 3090 patients.

    Science.gov (United States)

    Weintraub, Daniel; Koester, Juergen; Potenza, Marc N; Siderowf, Andrew D; Stacy, Mark; Voon, Valerie; Whetteckey, Jacqueline; Wunderlich, Glen R; Lang, Anthony E

    2010-05-01

    An association between dopamine-replacement therapies and impulse control disorders (ICDs) in Parkinson disease (PD) has been suggested in preliminary studies. To ascertain point prevalence estimates of 4 ICDs in PD and examine their associations with dopamine-replacement therapies and other clinical characteristics. Cross-sectional study using an a priori established sampling procedure for subject recruitment and raters blinded to PD medication status. Three thousand ninety patients with treated idiopathic PD receiving routine clinical care at 46 movement disorder centers in the United States and Canada. The Massachusetts Gambling Screen score for current problem/pathological gambling, the Minnesota Impulsive Disorders Interview score for compulsive sexual behavior and buying, and Diagnostic and Statistical Manual of Mental Disorders research criteria for binge-eating disorder. An ICD was identified in 13.6% of patients (gambling in 5.0%, compulsive sexual behavior in 3.5%, compulsive buying in 5.7%, and binge-eating disorder in 4.3%), and 3.9% had 2 or more ICDs. Impulse control disorders were more common in patients treated with a dopamine agonist than in patients not taking a dopamine agonist (17.1% vs 6.9%; odds ratio [OR], 2.72; 95% confidence interval [CI], 2.08-3.54; P disorder frequency was similar for pramipexole and ropinirole (17.7% vs 15.5%; OR, 1.22; 95% CI, 0.94-1.57; P = .14). Additional variables independently associated with ICDs were levodopa use, living in the United States, younger age, being unmarried, current cigarette smoking, and a family history of gambling problems. Dopamine agonist treatment in PD is associated with 2- to 3.5-fold increased odds of having an ICD. This association represents a drug class relationship across ICDs. The association of other demographic and clinical variables with ICDs suggests a complex relationship that requires additional investigation to optimize prevention and treatment strategies. clinicaltrials

  11. Pathological generosity: an atypical impulse control disorder after a left subcortical stroke.

    Science.gov (United States)

    Ferreira-Garcia, Rafael; Fontenelle, Leonardo F; Moll, Jorge; de Oliveira-Souza, Ricardo

    2014-01-01

    Changes in socio-emotional behavior and conduct, which are characteristic symptoms of frontal lobe damage, have less often been described in patients with focal subcortical injuries. We report on a case of pathological generosity secondary to a left lenticulocapsular stroke with hypoperfusion of several anatomically intact cortical areas. A 49-year-old man developed excessive and persistent generosity as he recovered from a left lenticulocapsular hematoma. His symptoms resembled an impulse control disorder. (99m)Tc-HMPAO SPECT demonstrated hypoperfusion mostly in the ipsilateral striatum, dorsolateral, and orbitofrontal cortex. This case study adds pathological generosity to the range of behavioral changes that may result from discrete unilateral lesions of the lenticular nucleus and nearby pathways. In our particular case, post-stroke pathological generosity was not ascribable to disinhibition, apathy, mania, or depression. Because pathological generosity may lead to significant distress and financial burden upon patients and their families, it may warrant further consideration as a potential type of impulse control disorder.

  12. The risky business of dopamine agonists in Parkinson disease and impulse control disorders

    NARCIS (Netherlands)

    Claassen, D.O.; van den Wildenberg, W.P.M.; Ridderinkhof, K.R.; Jessup, C.K.; Harrison, M.B.; Wooten, G.F.; Wylie, S.A.

    2011-01-01

    Risk-taking behavior is characterized by pursuit of reward in spite of potential negative consequences. Dopamine neurotransmission along the mesocorticolimbic pathway is a potential modulator of risk behavior. In patients with Parkinson's disease (PD), impulse control disorder (ICD) can result from

  13. Impulse control disorders in Parkinson's disease: definition, epidemiology, risk factors, neurobiology and management.

    Science.gov (United States)

    Ceravolo, Roberto; Frosini, Daniela; Rossi, Carlo; Bonuccelli, Ubaldo

    2009-12-01

    There is increasing awareness that impulse control disorders (ICDs), including pathological gambling, hyper-sexuality, compulsive eating and buying, can occur as a complication of Parkinson's disease (PD). In addition, other impulsive or compulsive disorders have been reported to occur, including dopamine dysregulation syndrome (DDS) and punding. Case reports and prospective studies have reported an association between ICDs and the use of dopamine receptor agonists at higher doses, and DDS has been associated with L-dopa at higher doses or short-acting dopamine receptor agonists. Risk factors for ICDs include male sex, younger age or younger age at PD onset, a pre-PD history of ICD symptoms, history of substance use or bipolar disorder, and a personality profile characterized by impulsiveness. The management of clinically significant ICD symptoms should consist of modifications to dopamine replacement therapy, particularly dopamine receptor agonists, which is usually associated with an improvement of ICDs. There is no empirical evidence supporting the use of psychiatric drugs for ICDs in PD. Functional neuroimaging studies such as functional MRI and PET can investigate in vivo the neurobiological basis of these pathological behaviours. Copyright 2009 Elsevier Ltd. All rights reserved.

  14. Apathy and impulse control disorders in Parkinson's disease: a direct comparison.

    Science.gov (United States)

    Leroi, Iracema; Andrews, Michelle; McDonald, Kathryn; Harbishettar, Vijay; Elliott, Rebecca; Byrne, E Jane; Burns, Alistair

    2012-02-01

    Apathy and impulse control disorders (ICDs) in Parkinson's disease (PD) are clinically important complications and may exist on a common behavioral spectrum of disorders of reward and motivation. To directly compare PD participants with apathy those with ICDs on range of demographic, neurologic and psychiatric measures. Ninety-nine non-demented PD participants (ICD, n = 35; apathy, n = 26; and controls, n = 38) were assessed in the study. Univariate statistics were used to compare the behavioral groups. A linear regression model was created with either apathy or impulsivity as the dependent variable. The two behavioral groups differed significantly from the PD control group on similar factors but in opposite directions. The apathy group was older at the time of both assessment and disease onset, had higher levels of depression and lower dopamine agonist use, compared to the other two groups. The ICD group was younger than the apathy group at disease onset and had higher levels of anxiety, a higher overall dopamine load and greater motor disease complexity. Overlap in behavioral pathology across the two groups was also noted. Apathy and ICDs may be on a common behavioral spectrum in PD. Both are associated with significant psychiatric morbidity supporting shared underlying pathology. Copyright © 2011 Elsevier Ltd. All rights reserved.

  15. [Antiepileptic drugs in the control of the impulses disorders].

    Science.gov (United States)

    Roncero, C; Rodríguez-Urrutia, A; Grau-López, L; Casas, M

    2009-01-01

    The disorders classified as control of the impulses; explosive intermittent disorder, pathological gambling, kleptomania, pyromania, pathological gambling, hair pullers, compulsive purchases, skin picking and onychophagia are a heterogeneous set of clinical entities, most of them with little prevalence. Nevertheless, they cause important personal and social dysfunctions and present great comorbidity with other psychiatric disorders. Antipsychotics, antidepressive agents, serotoninergic agonists, naltrexone, beta blockers antiandrogen, lithium and anticonvulsants have been used in their pharmacological treatment. Currently, interest is growing on the use of the antiepileptics because their possible usefulness has been described in these disorders. However, the neurobiological effects are only partially known in some cases. We have reviewed the literature regarding the treatment of these disorders with mood stabilizers, (lithium, carbamazepine, valproate, phenitoin, oxcarbacepin, topiramate, lamotrigin, leviteracetam) and have described those studies on which the current knowledge and evidence are based. The results must be considered as provisional and must be updated in the future, since they are mostly based on case reports, case series or opened clinical trials, their being little knowledge based on double blind clinical trials.

  16. Maternal impulse control disability and developmental disorder traits are risk factors for child maltreatment.

    Science.gov (United States)

    Tachibana, Yoshiyuki; Takehara, Kenji; Kakee, Naoko; Mikami, Masashi; Inoue, Eisuke; Mori, Rintaro; Ota, Erika; Koizumi, Tomoe; Okuyama, Makiko; Kubo, Takahiko

    2017-11-14

    Previous work has suggested that maternal developmental disorder traits related to autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) are significantly associated with child maltreatment. However, there may be other important maternal characteristics that contribute to child maltreatment. We hypothesized that maternal impulse control disability may also affect child maltreatment in addition to maternal developmental disorder traits. We aimed to test this hypothesis via a cohort study performed in Tokyo (n = 1,260). Linear regression analyses using the Behavioural Inhibition/Behavioural Activation Scales, the self-administered short version of the Pervasive Developmental Disorders Autism Society Japan Rating Scale, the short form of the Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale, and the Child Maltreatment Scale, revealed that excessive inhibition of behaviour and affect, which is impulse control disability, is significantly associated with child maltreatment (b = 0.031, p = 0.018) in addition to maternal developmental disorder traits (ASD: b = 0.052, p = 0.004; ADHD: b = 0.178, p child maltreatment, while ADHD was associated (AOR = 1.034, p = 0.022) with severe child maltreatment. These maternal characteristics may inform the best means for prevention and management of child maltreatment cases.

  17. Depression and impulse control disorders in Parkinson's disease : two sides of the same coin?

    NARCIS (Netherlands)

    Vriend, Chris; Pattij, Tommy; van der Werf, Ysbrand D; Voorn, Pieter; Booij, Jan; Rutten, Sonja; Berendse, Henk W; van den Heuvel, Odile A

    Depression and impulse control disorders (ICD) are two common neuropsychiatric features in Parkinson's disease (PD). Studies have revealed that both phenomena are associated with aberrations in ventral striatal dopamine signaling and concomitant dysfunction of the reward-related (limbic)

  18. Impulse control disorders in patients with Parkinson's disease.

    Science.gov (United States)

    Gescheidt, Tomás; Bares, Martin

    2011-03-01

    In patients with Parkinson's disease with higher prevalence than in current population there appear pathological behaviours characterized by compulsion, repetitiveness and impulsivity, which are connected with material profit or pleasurable experience. They are, in particular, pathological gambling, hypersexuality, compulsive shopping and compulsive eating (in the literature they are collectively referred to as impulse control disorders). Pathological preoccupation with repeated mechanical activities (so-called punding) and excessive compulsive intake of dopaminergic medication (so-called dopamine dysregulation syndrome or also syndrome of hedonistic homeostatic dysregulation) are of similar nature. The paper treats briefly the risk factors and prevalence of these pathological behaviours. In current clinical practice, these psychiatric complications frequently escape doctors' attention, they are underdiagnosed. Although no generally valid recommendations for their therapy are currently available, they can be influenced medically. Of advantage can be modified dopaminergic medication (usually dose reduction ofdopaminergic agonists); multidisciplinary approach to the problem is appropriate. The pathological behaviours given above can frequently lead to considerable material losses and markedly aggravate patients' handicap in the social sphere; it can be expected that in the future they can become a problem also from the ethical and legal points of view.

  19. [Clinical and psychopathological factors associated with impulse control disorders in Parkinson's disease].

    Science.gov (United States)

    Sáez-Francàs, N; Martí Andrés, G; Ramírez, N; de Fàbregues, O; Álvarez-Sabín, J; Casas, M; Hernández-Vara, J

    2016-05-01

    Impulse control disorders (ICD) constitute a complication that may arise during the course of Parkinson's disease (PD). Several factors have been linked to the development of these disorders, and their associated severe functional impairment requires specific and multidisciplinary management. The objective of this study was to evaluate the frequency of ICDs and the clinical and psychopathological factors associated with the appearance of these disorders. Cross-sectional, descriptive, and analytical study of a sample of 115 PD patients evaluated to determine the presence of an ICD. Clinical scales were administered to assess disease severity, personality traits, and presence of psychiatric symptoms at the time of evaluation. Of the 115 patients with PD, 27 (23.48%) displayed some form of ICD; hypersexuality, exhibited by 14 (12.2%), and binge eating, present in 12 (10.1%), were the most common types. Clinical factors associated with ICD were treatment with dopamine agonists (OR: 13.39), earlier age at disease onset (OR: 0.92), and higher score on the UPDRS-I subscale; psychopathological factors with a significant association were trait anxiety (OR: 1.05) and impulsivity (OR: 1.13). ICDs are frequent in PD, and treatment with dopamine agonists is the most important risk factor for these disorders. High impulsivity and anxiety levels at time of evaluation, and younger age at disease onset, were also linked to increased risk. However, presence of these personality traits prior to evaluation did not increase risk of ICD. Copyright © 2015 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

  20. Associations between DSM-IV mental disorders and diabetes mellitus: a role for impulse control disorders and depression

    Science.gov (United States)

    Alonso, Jordi; Stein, Dan J.; Kiejna, Andrzej; Aguilar-Gaxiola, Sergio; Viana, Maria Carmen; Liu, Zhaorui; O’Neill, Siobhan; Bruffaerts, Ronny; Caldas-de-Almeida, Jose Miguel; Lepine, Jean-Pierre; Matschinger, Herbert; Levinson, Daphna; de Girolamo, Giovanni; Fukao, Akira; Bunting, Brendan; Haro, Josep Maria; Posada-Villa, Jose A.; Al-Hamzawi, Ali Obaid; Medina-Mora, Maria Elena; Piazza, Marina; Hu, Chiyi; Sasu, Carmen; Lim, Carmen C. W.; Kessler, Ronald C.; Scott, Kate M.

    2014-01-01

    Aims/hypothesis No studies have evaluated whether the frequently observed associations between depression and diabetes could reflect the presence of comorbid psychiatric conditions and their associations with diabetes. We therefore examined the associations between a wide range of pre-existing Diagnostic Statistical Manual, 4th edition (DSM-IV) mental disorders with self-reported diagnosis of diabetes. Methods We performed a series of cross-sectional face-to-face household surveys of community-dwelling adults (n=52,095) in 19 countries. The World Health Organization Composite International Diagnostic Interview retrospectively assessed lifetime prevalence and age at onset of 16 DSM-IV mental disorders. Diabetes was indicated by self-report of physician’s diagnosis together with its timing. We analysed the associations between all mental disorders and diabetes, without and with comorbidity adjustment. Results We identified 2,580 cases of adult-onset diabetes mellitus (21 years +). Although all 16 DSM-IV disorders were associated with diabetes diagnosis in bivariate models, only depression (OR 1.3; 95% CI 1.1, 1.5), intermittent explosive disorder (OR 1.6; 95% CI 1.1, 2.1), binge eating disorder (OR 2.6; 95% CI 1.7, 4.0) and bulimia nervosa (OR 2.1; 95% CI 1.3, 3.4) remained after comorbidity adjustment. Conclusions/interpretation Depression and impulse control disorders (eating disorders in particular) were significantly associated with diabetes diagnosis after comorbidity adjustment. These findings support the focus on depression as having a role in diabetes onset, but suggest that this focus may be extended towards impulse control disorders. Acknowledging the comorbidity of mental disorders is important in determining the associations between mental disorders and subsequent diabetes. PMID:24488082

  1. Impulse control disorders and related behaviours (ICD-RBs in Parkinson′s disease patients: Assessment using “Questionnaire for impulsive-compulsive disorders in Parkinson′s disease” (QUIP

    Directory of Open Access Journals (Sweden)

    Ashish Sharma

    2015-01-01

    Full Text Available Background: There is limited data on the prevalence of impulse control disorder and related behaviors (ICD-RBs in Indian patients with Parkinson′s Disease (PD. In the context of potential genetic and environmental factors affecting the expression of ICD-RBs, studying other multiethnic populations may bring in-sights into the mechanisms of these disorders. Objectives: To ascertain point prevalence estimate of ICD-RBs in Indian PD patients, using the validated “Questionnaire for Impulsive-Compulsive Disorders in Parkinson′s disease (QUIP” and to examine their association with Dopamine replacement therapy (DRT. Materials and Methods: This was a hospital based observational cross-sectional study. After taking informed consent, patients and their informants (spouse, or primary caregiver were made to complete the QUIP, and were instructed to answer questions based on behaviors that occurred anytime during PD that lasted at least four consecutive weeks. Results: Total of 299 patients participated in the study. At least one ICD-RB was present in 128 (42.8%, at least one Impulse control disorder (ICD was present in 74 (24.75% and at least one Impulse control related compulsive behaviour (ICRB was present in 93 (31.1% patients. Punding was the most frequent (12.4% followed by hyper sexuality (11.04%, compulsive hobbyism (9.4%, compulsive shopping (8.4%, compulsive medication use (7.7%, compulsive eating (5.35%, walkabout (4% and pathological gambling (3.3%. ≥ 2 ICD-RBs were observed in 15.7% of patients. After multivariate analysis, younger age of onset, being unmarried were specifically associated with presence of ICD. Longer disease duration was specifically associated with presence of ICRB. Whereas smoking and higher dopamine levodopa equivalent daily doses (DA LEDD were associated with both presence of ICD and ICRB. Higher LD LEDD was specifically associated with presence of ICD-RB. Conclusions: Our study revealed a relatively higher

  2. Dopaminergic influences on executive function and impulsive behaviour in impulse control disorders in Parkinson's disease.

    Science.gov (United States)

    Leroi, Iracema; Barraclough, Michelle; McKie, Shane; Hinvest, Neal; Evans, Jonathan; Elliott, Rebecca; McDonald, Kathryn

    2013-09-01

    The development of impulse control disorders (ICDs) in Parkinson's disease (PD) may arise from an interaction among cognitive impairment, impulsive responding and dopaminergic state. Dopaminergic state may be influenced by pharmacologic or genotypic (catechol-O-methyltransferase; COMT) factors. We sought to investigate this interaction further by comparing those with (n = 35) and without (n = 55) ICDs on delay-discounting in different pharmacologic conditions (ON or OFF dopaminergic medication) and on response inhibition as well as aspects of executive functioning in the ON state. We then undertook an exploratory sub-group analysis of these same tasks when the overall PD group was divided into different allelic variants of COMT (val/val vs. met/met). A healthy control group (HC; n = 20) was also included. We found that in those with PD and ICDs, 'cognitive flexibility' (set shifting, verbal fluency, and attention) in the ON medication state was not impaired compared with those without ICDs. In contrast, our working memory, or 'cognitive focus', task was impaired in both PD groups compared with the HC group when ON. During the delay-discounting task, the PD with ICDs group expressed greater impulsive choice compared with the PD group without ICDs, when in the ON, but not the OFF, medication state. However, no group difference on the response inhibition task was seen when ON. Finally, the met homozygous group performed differently on tests of executive function compared with the val homozygous group. We concluded that the disparity in levels of impairment among different domains of executive function and impulsive decision-making distinguishes those with ICD in PD from those without ICD, and may in part be affected by dopaminergic status. Both pharmacologic and genotypic influences on dopaminergic state may be important in ICD. © 2013 The British Psychological Society.

  3. Proficient motor impulse control in Parkinson disease patients with impulsive and compulsive behaviors

    NARCIS (Netherlands)

    Claassen, D.O.; van den Wildenberg, W.P.; Harrison, M.B.; van Wouwe, N.C.; Kanoff, K.; Neimat, J.S.; Wylie, S.A.

    2015-01-01

    BACKGROUND: Parkinson disease (PD) patients treated with dopamine agonist therapy can develop maladaptive reward-driven behaviors, known as impulse control disorder (ICD). In this study, we assessed if ICD patients have evidence of motor-impulsivity. METHODS: We used the stop-signal task in a cohort

  4. Screening for impulse control symptoms in patients with de novo Parkinson disease: a case-control study.

    Science.gov (United States)

    Weintraub, Daniel; Papay, Kimberly; Siderowf, Andrew

    2013-01-08

    To determine the frequency and correlates of impulse control and related behavior symptoms in patients with de novo, untreated Parkinson disease (PD) and healthy controls (HCs). The Parkinson's Progression Markers Initiative is an international, multisite, case-control clinical study conducted at 21 academic movement disorders centers. Participants were recently diagnosed, untreated PD patients (n = 168) and HCs (n = 143). The outcome measures were presence of current impulse control and related behavior symptoms based on recommended cutoff points for the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease (QUIP)-Short Form. There were 311 participants with complete QUIP data. Frequencies of impulse control and related behavior symptoms for patients with PD vs HCs were as follows: gambling (1.2% vs. 0.7%), buying (3.0% vs. 2.1%), sexual behavior (4.2% vs. 3.5%), eating (7.1% vs. 10.5%), punding (4.8% vs. 2.1%), hobbyism (5.4% vs. 11.9%), walkabout (0.6% vs. 0.7%), and any impulse control or related behavior (18.5% vs. 20.3%). In multivariable models, a diagnosis of PD was not associated with symptoms of any impulse control or related behavior (p ≥ 0.10 in all cases). PD itself does not seem to confer an increased risk for development of impulse control or related behavior symptoms, which further reinforces the reported association between PD medications and impulse control disorders in PD. Given that approximately 20% of patients with newly diagnosed PD report some impulse control or related behavior symptoms, long-term follow-up is needed to determine whether such patients are at increased risk for impulse control disorder development once PD medications are initiated.

  5. ICARUS study: prevalence and clinical features of impulse control disorders in Parkinson's disease.

    Science.gov (United States)

    Antonini, Angelo; Barone, Paolo; Bonuccelli, Ubaldo; Annoni, Karin; Asgharnejad, Mahnaz; Stanzione, Paolo

    2017-04-01

    Impulse control disorders/other compulsive behaviours ('ICD behaviours') occur in Parkinson's disease (PD), but prospective studies are scarce, and prevalence and clinical characteristics of patients are insufficiently defined. To assess the presence of ICD behaviours over a 2-year period, and evaluate patients' clinical characteristics. A prospective, non-interventional, multicentre study (ICARUS (Impulse Control disorders And the association of neuRopsychiatric symptoms, cognition and qUality of life in ParkinSon disease); SP0990) in treated Italian PD outpatients. Study visits: baseline, year 1, year 2. Surrogate primary variable: presence of ICD behaviours and five ICD subtypes assessed by modified Minnesota Impulsive Disorder Interview (mMIDI). 1069/1095 (97.6%) patients comprised the Full Analysis Set. Point prevalence of ICD behaviours (mMIDI; primary analysis) was stable across visits: 28.6% (306/1069) at baseline, 29.3% (292/995) at year 1, 26.5% (245/925) at year 2. The most prevalent subtype was compulsive eating, followed by punding, compulsive sexual behaviour, gambling and buying disorder. Patients who were ICD positive at baseline were more likely to be male, younger, younger at PD onset, have longer disease duration, more severe non-motor symptoms (including mood and sexual function), depressive symptoms, sleep impairment and poorer PD-related quality of life. However, they did not differ from the ICD-negative patients in their severity of PD functional disability, motor performance and cognitive function. Prevalence of ICD behaviours was relatively stable across the 2-year observational period. ICD-positive patients had more severe depression, poorer sleep quality and reduced quality of life. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  6. Impulsivity in adolescents with major depressive disorder: A comparative tunisian study.

    Science.gov (United States)

    Khemakhem, Khaoula; Boudabous, Jaweher; Cherif, Leila; Ayadi, Hela; Walha, Adel; Moalla, Yousr; Hadjkacem, Imen; Ghribi, Farhat

    2017-08-01

    The association between impulsivity and depressive disorders in adolescence has been little studied at the literature and in our country, yet impulsivity is a major risk factor for suicide. Thus we aimed on this study to evaluate impulsivity in 25 adolescents with Major Depressive Disorder MDD compared to a control sample and to analyze the correlations between impulsivity and clinical features of MDD. Employing a matched case-control design, participants included 25 adolescents with MDD and 75 controls. We have administered the Barratt Impulsivity Scale BIS-11 for the two groups to evaluate impulsivity. Semi structured interviews according DSM 5 criteria were conducted for adolescents with MDD. The Child Depressive Inventory CDI was used to measure depressive symptoms in the control sample. Adolescents with MDD were more impulsive compared to controls according to the BIS-11 in its three domains: motor (24.96±6.26 against 20.6±4.84; p=0.000), attentional (20.88±5.03 against 16.64±3.2; p=0.000) and non planning (28.2±7.26 against 24.44±4.32; p=0.02). Impulsivity was not correlated with clinical features of MDD (suicide attempts, psychiatric comorbidities, antidepressant medication …). Adolescents with MDD seem to be more impulsive than control subjects regardless their clinical features. Whether it is a specific characteristic or a symptom among others of MDD, impulsivity predicts health-related behaviors and associated damage that need to be detected and prevented in time. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Attention and impulse control in children with borderline intelligence with or without conduct disorder.

    NARCIS (Netherlands)

    van der Meere, Jaap; van der Meer, Dirk-Jan; Borger, Norbert; Pirila, Silja

    2008-01-01

    This study was designed to investigate attention and impulse control in 21 boys with dual diagnoses of conduct disorder and borderline intelligence and in 19 boys with borderline intelligence only. Using the Continuous Performance Test A-not-X, it appeared that children with the dual diagnosis made

  8. A multidimensional approach of impulsivity in adult attention deficit hyperactivity disorder.

    Science.gov (United States)

    Lopez, Régis; Dauvilliers, Yves; Jaussent, Isabelle; Billieux, Joël; Bayard, Sophie

    2015-06-30

    We aimed to compare adult patients with attention deficit hyperactivity disorder (ADHD) and matched controls on four dimensions of impulsivity (urgency, lack of premeditation, lack of perseverance, and sensation seeking) and to examine the association between impulsivity and ADHD symptoms. The study was conducted on 219 participants: 72 adult ADHD patients and 147 aged and gender matched controls. All participants completed questionnaires measuring the various facets of impulsivity (UPPS Impulsive Behavior Scale), ADHD and depressive symptoms severity. Patients were also assessed for ADHD subtypes, mood disorders, and addictive behaviors. ADHD patients exhibited higher urgency, lower premeditation and lower perseverance in comparison to controls. Lack of perseverance showed the strongest association with ADHD (area under curve=0.95). Patients with combined inattentive and hyperactive/impulsive subtypes reported more frequently substance abuse problems and had higher scores on urgency and sensation seeking dimensions of impulsivity than those with predominantly inattentive subtype. We report for the first time a multidimensional evaluation of impulsivity in adult ADHD patients. The UPPS Impulsive Behavior Scale may constitute a useful screening tool for ADHD in adults and may help to further understanding the psychological mechanisms underlying the differences between the ADHD subgroups. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. Impulse Control and Related Disorders in Parkinson's Disease.

    Science.gov (United States)

    Weintraub, Daniel; Claassen, Daniel O

    2017-01-01

    Impulse control disorders (ICDs), such as compulsive gambling, buying, sexual, and eating behaviors, are a serious and increasingly recognized complication in Parkinson's disease (PD), occurring in up to 20% of PD patients over the course of their illness. Related behaviors include punding (stereotyped, repetitive, purposeless behaviors), dopamine dysregulation syndrome (DDS) (compulsive medication overuse), and hobbyism (e.g., compulsive internet use, artistic endeavors, and writing). These disorders have a significant impact on quality of life and function, strain interpersonal relationships, and worsen caregiver burden, and are associated with significant psychiatric comorbidity. ICDs have been most closely related to the use of dopamine agonists (DAs), while DDS is primarily associated with shorter acting, higher potency dopamine replacement therapy (DRT), such as levodopa. However, in preliminary research ICDs have also been reported to occur with monoamine oxidase inhibitor-B and amantadine treatment, and after deep brain stimulation (DBS) surgery. Other risk factors for ICDs may include sex (e.g., male sex for compulsive sexual behavior, and female sex for compulsive buying behavior); younger age overall at PD onset; a pre-PD history of an ICD; personal or family history of substance abuse, bipolar disorder, or gambling problems; and impulsive personality traits. Dysregulation of the mesocorticolimbic dopamine system is thought to be the major neurobiological substrate for ICDs in PD, but there is preliminary evidence for alterations in opiate and serotonin systems too. The primary treatment of ICDs in PD is discontinuation of the offending treatment, but not all patients can tolerate this due to worsening motor symptoms or DA withdrawal syndrome. While psychiatric medications and psychosocial treatments are frequently used to treat ICDs in the general population, there is limited empirical evidence for their use in PD, so it is critical for patients to be

  10. Association between REM sleep behaviour disorder and impulse control disorder in patients with Parkinson's disease.

    Science.gov (United States)

    Bellosta Diago, E; Lopez Del Val, L J; Santos Lasaosa, S; López Garcia, E; Viloria Alebesque, A

    2017-10-01

    The relationship between impulse control disorder (ICD) and REM sleep behaviour disorder (RBD) has not yet been clarified, and the literature reports contradictory results. Our purpose is to analyse the association between these 2 disorders and their presence in patients under dopaminergic treatment. A total of 73 patients diagnosed with Parkinson's disease and treated with a single dopamine agonist were included in the study after undergoing clinical assessment and completing the single-question screen for REM sleep behaviour disorder and the short version of the questionnaire for impulsive-compulsive behaviours in Parkinson's disease. Mean age was 68.88 ± 7.758 years. Twenty-six patients (35.6%) were classified as probable-RBD. This group showed a significant association with ICD (P=.001) and had a higher prevalence of non-tremor akinetic rigid syndrome and longer duration of treatment with levodopa and dopamine agonists than the group without probable-RBD. We found a significant correlation between the use of oral dopamine agonists and ICD. Likewise, patients treated with oral dopamine agonists demonstrated a greater tendency toward presenting probable-RBD than patients taking dopamine agonists by other routes; the difference was non-significant. The present study confirms the association between RBD and a higher risk of developing symptoms of ICD in Parkinson's disease. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Repetitive urges to inflict burns: An unusual presentation of impulse control disorder.

    Science.gov (United States)

    Pal, Arghya; Parmar, Arpit; Pattanayak, Raman Deep

    2016-01-01

    Impulse control disorders (ICDs) are characterized by an inability to resist an intense impulse or drive to perform a particular act that is excessive and/or harmful to self/others. Till date, there is no published report of an ICD presenting with repetitive urges to inflict burns. We describe the case of an adult male in regular follow-up for 6 months who presented with intense, irresistible, and repetitive urges and acts of causing burns on his skin for past 1 year. The phenomenology shared the core qualities described for ICDs and patient showed adequate response to treatment. The case report describes an unusual type of ICD classifiable as not otherwise specified. More clinical and research attention is warranted toward ICDs in general, with implications for ICD-11.

  12. Repetitive urges to inflict burns: An unusual presentation of impulse control disorder

    Directory of Open Access Journals (Sweden)

    Arghya Pal

    2016-01-01

    Full Text Available Impulse control disorders (ICDs are characterized by an inability to resist an intense impulse or drive to perform a particular act that is excessive and/or harmful to self/others. Till date, there is no published report of an ICD presenting with repetitive urges to inflict burns. We describe the case of an adult male in regular follow-up for 6 months who presented with intense, irresistible, and repetitive urges and acts of causing burns on his skin for past 1 year. The phenomenology shared the core qualities described for ICDs and patient showed adequate response to treatment. The case report describes an unusual type of ICD classifiable as not otherwise specified. More clinical and research attention is warranted toward ICDs in general, with implications for ICD-11.

  13. Neuropsychological performance, impulsivity, ADHD symptoms, and novelty seeking in compulsive buying disorder.

    Science.gov (United States)

    Black, Donald Wayne; Shaw, Martha; McCormick, Brett; Bayless, John David; Allen, Jeff

    2012-12-30

    We examined the neuropsychological performance of people with compulsive buying disorder (CBD) and control subjects, along with trait impulsivity, symptoms of attention deficit hyperactivity disorder (ADHD), and selected personality characteristics. Subjects received a comprehensive neuropsychological test battery, depression and ADHD symptom assessment, the Barratt Impulsiveness Scale, and a version of the Temperament and Character Inventory. Persons with CBD (n=26) and controls (n=32) were comparable in terms of age, sex, and years of education. Subjects with CBD had a mean age of 36.3 years (S.D.=15.7) and an age at onset of 19.7 years (S.D.=7.0). Compulsive buyers had more lifetime mood, anxiety, and impulse control disorders. People with Compulsive buying performed significantly better on the Wechsler Abbreviated Scale of Intelligence Picture Completion task, a test of visual perception; otherwise, there were no consistent differences in neuropsychological measures. They also had elevated levels of self-reported depression, ADHD symptoms, trait impulsivity, and novelty seeking. In conclusion, compulsive buyers have greater lifetime psychiatric comorbidity than controls, and higher levels of self-rated depression, ADHD symptoms, trait impulsivity, and novelty seeking. The present study does not support the notion that there is a pattern of neuropsychological deficits associated with CBD. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  14. Behavioural addictions in bipolar disorder patients: role of impulsivity and personality dimensions.

    Science.gov (United States)

    Di Nicola, Marco; Tedeschi, Daniela; Mazza, Marianna; Martinotti, Giovanni; Harnic, Desiree; Catalano, Valeria; Bruschi, Angelo; Pozzi, Gino; Bria, Pietro; Janiri, Luigi

    2010-09-01

    Behavioural addictions (BAs) can be understood as disorders characterized by repetitive occurrence of impulsive and uncontrolled behaviours. Very few studies have investigated their association with mood disorders. The present study was undertaken to determine the prevalence of the main behavioural addictions in a sample of bipolar outpatients in euthymic phase or stabilised by medications and to investigate the role of impulsivity and temperamental and character dimensions. One-hundred-fifty-eight Bipolar Disorder (BD) (DSM-IV) outpatients were assessed with tests designed to screen the main behavioural addictions: pathological gambling (SOGS), compulsive shopping (CBS), sexual (SAST), Internet (IAD), work (WART) and physical exercise (EAI) addictions. TCI-R and BIS-11 were administered to investigate impulsivity and personality dimensions mainly associated with BAs. The clinical sample has been compared with 200 matched healthy control subjects. In bipolar patients, 33% presented at least one BA respect to the 13% of controls. Significantly higher scores at the scales for pathological gambling (paddictions (paddictions in BD showing a significant association of these disorders. BAs are more frequent in bipolar patients than in healthy controls and are related to higher impulsivity levels and character immaturity. 2010 Elsevier B.V. All rights reserved.

  15. Impulsive behavior in adults with attention deficit/ hyperactivity disorder: characterization of attentional, motor and cognitive impulsiveness.

    Science.gov (United States)

    Malloy-Diniz, L; Fuentes, D; Leite, W Borges; Correa, H; Bechara, A

    2007-07-01

    Attention-deficit/hyperactivity disorder (ADHD) is characterized by inattention and/or hyperactivity/impulsivity. Impulsivity persists in adults with ADHD and might be the basis of much of the impairment observed in the daily lives of such individuals. The objective of this study was to address the presence, and more importantly, the three dimensions of impulsivity: attentional, non-planning and motor, in how they may relate to neuropsychological mechanisms of impulse control. We studied a sample of 50 adults with ADHD and 51 healthy comparison controls using the Barratt Impulsivity Scale Version 11 (BIS), and neuropsychological tasks, namely the Continuous Performance Task (CPT-II) and the Iowa Gambling Task (IGT). The ADHD group showed more signs of impulsivity on the three dimensions of BIS, committed more errors of omission and commission on the CPT-II, and made more disadvantageous choices on the IGT. These results support the existence of deficits related to three components of impulsivity: motor, cognitive, and attentional among adults with ADHD. Most importantly, this study also highlights the complementary nature of self-report questionnaires and neuropsychological tasks in the assessment of impulsivity in ADHD adults.

  16. Impact of Impulse Control Disorders on Sleep-Wake Regulation in Parkinson’s Disease

    Directory of Open Access Journals (Sweden)

    Atbin Djamshidian

    2015-01-01

    Full Text Available Sleep disturbances are common in patients with Parkinson’s disease (PD and are even more prevalent in patients with behavioural addictions, such as pathological gambling, compulsive sexual behaviour, compulsive buying, binge eating, punding, and the compulsive use of dopamine replacement therapy. An overview of the relationship between these impulse control disorders and sleep disturbances is given and potential underlying mechanisms and treatment strategies are covered.

  17. Borderline personality disorder symptoms and criminal justice system involvement: The roles of emotion-driven difficulties controlling impulsive behaviors and physical Aggression.

    Science.gov (United States)

    Moore, Kelly E; Tull, Matthew T; Gratz, Kim L

    2017-07-01

    Borderline personality disorder (BPD) is associated with elevated risk for a variety of risky behaviors, including criminal behaviors. Yet, limited research has examined the relation of BPD to criminal justice (CJ) involvement, or the mechanisms underlying this relation. This study examined the role of two mechanisms, emotion-driven difficulties controlling impulsive behaviors and physical aggression, in the relation between BPD symptom severity and CJ involvement among 118 patients in residential substance abuse treatment (76% male; 62% African-American). Participants completed measures of BPD symptom severity, CJ contact, diversity of CJ charges, emotion-driven impulse control difficulties, physical aggression, and covariates (substance use severity and antisocial personality disorder symptoms). BPD symptom severity was associated with CJ contact through emotion-driven difficulties controlling impulsive behaviors, and with diversity of CJ charges through emotion-driven difficulties controlling impulsive behaviors and physical aggression; however, the indirect relations to diversity of CJ charges became non-significant when covariates were included. Results highlight the important role of emotion-driven difficulties controlling impulsive behaviors in criminal behaviors among individuals with BPD symptoms, as well as the potential clinical utility of targeting this mechanism to prevent CJ involvement and/or recidivism. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. [Impulsiveness Among Short-Term Prisoners with Antisocial Personality Disorder].

    Science.gov (United States)

    Lang, Fabian U; Otte, Stefanie; Vasic, Nenad; Jäger, Markus; Dudeck, Manuela

    2015-07-01

    The study aimed to investigate the correlation between impulsiveness and the antisocial personality disorder among short-term prisoners. The impulsiveness was diagnosed by the Barratt Impulsiveness Scale (BIS). Short-term prisoners with antisocial personality disorder scored significant higher marks on the BIS total scale than those without any personality disorder. In detail, they scored higher marks on each subscale regarding attentional, motor and nonplanning impulsiveness. Moderate and high effects were calculated. It is to be considered to regard impulsivity as a conceptual component of antisociality. © Georg Thieme Verlag KG Stuttgart · New York.

  19. Impulsivity, aggression and suicidal behavior in unipolar and bipolar disorders.

    Science.gov (United States)

    Perroud, Nader; Baud, Patrick; Mouthon, Dominique; Courtet, Philippe; Malafosse, Alain

    2011-11-01

    Predictors of suicidal behaviors (SB) in bipolar (BD) and major depressive disorder (MDD) patients are poorly understood. It has been recognized that behavioral dysregulation characterizes SB with traits of impulsivity and aggression being particularly salient. However, little is known about how these traits are segregated among mood disorder patients with and without a history of suicide attempt (SA). This article aims to compare impulsivity and aggression between 143 controls, 138 BD and 186 MDD subjects with or without a history of SA. BD and MDD patients showed higher impulsivity scores (BIS-10 = 57.9 vs. 44.7, p impulsivity helped to distinguish MDD subjects without a history of SA from those with such a history, this was not the case in BD subjects where no difference in impulsive traits was observed between BD without and with history of SA (57.2 vs. 63.2 for BIS-10; p = 0.259). Impulsive and aggressive traits were strongly correlated in suicide attempters (independently of the diagnosis) but not in non-suicide attempters. Dimensional traits were not characterized at different stages of illness. Impulsivity, as a single trait, may be a reliable suicide risk marker in MDD but not in BD patients, and its strong correlation with aggressive traits seems specifically related to SB. Our study therefore suggests that the specific dimension of impulsive aggression should be systematically assessed in mood disorder patients to address properly their suicidal risk. Copyright © 2011 Elsevier B.V. All rights reserved.

  20. Long-Term Follow-Up of Impulse Control Disorders in Parkinson’s Disease

    OpenAIRE

    Mamikonyan, Eugenia; Siderowf, Andrew D.; Duda, John E.; Potenza, Marc N.; Horn, Stacy; Stern, Matthew B.; Weintraub, Daniel

    2008-01-01

    Recent studies have linked dopamine agonist (DA) usage with the development of impulse control disorders (ICDs) in Parkinson’s disease (PD). Little is known about optimal management strategies or the long-term outcomes of affected patients. To report on the clinical interventions and long-term outcomes of PD patients who developed an ICD after DA initiation. Subjects contacted by telephone for a follow-up interview after a mean time period of 29.2 months. They were administered a modified Min...

  1. [Repetitive impulse-associated behavioral disorders in Parkinson's disease].

    Science.gov (United States)

    Katzenschlager, R; Goerlich, K S; van Eimeren, T

    2012-12-01

    Parkinson's disease (PD) is associated with a number of behavioral disorders which may cause considerable social, professional or financial problems. Impulse control disorders (ICDs), such as pathological gambling, binge eating, compulsive shopping and hypersexuality occur in approximately 13-14% of PD patients. Further behavioral disorders are the dopamine dysregulation syndrome (DDS), a substance dependence characterized by craving for dopaminergic substances and punding (prolonged repetitive activities which are not goal-oriented).Treatment-related risk factors are dopamine agonists for ICDs and a high total dopaminergic dose for DDS and punding. Shared risk factors are young age at onset, impulsive personality traits, depression and possibly dyskinesia. At the neuronal level these behavioral disorders seem to be associated with changes in the reward system and dysfunction of the orbitofrontal cortex. The evidence level for management strategies is at present insufficient. For ICDs current clinical practice consists of discontinuation or reduction of dopamine agonists.

  2. [Emotional and impulsive dimensions in bipolar disorder and borderline personality disorder].

    Science.gov (United States)

    Leblanc, A; Jarroir, M; Vorspan, F; Bellivier, F; Leveillee, S; Romo, L

    2017-05-01

    Studies have shown that patients with borderline personality disorder are often misdiagnosed to have bipolar disorder and conversely. Indeed, a number of characteristics common to both disorders could explain this problem: emotional instability as well as impulsivity represent confounding factors and contribute to the risk of misdiagnosis. However, it appears that these characteristics manifest themselves in different ways according to the pathology. The aim of the study is to show differences between affective lability, emotional intensity and impulsivity dimensions. The clinical aim is to refine bipolar disorder and borderline personality disorder diagnosis, to improve psychological care for these patients in the long-term. We compared the emotional and impulsive dimensions in two groups of patients: a group of 21 patients with bipolar disorder and a group of 19 patients with borderline personality disorder. Tools: ALS, a self-report questionnaire to evaluate affective lability, AIM, a self-report questionnaire to see affective intensity, and UPPS, a self-report questionnaire to measure impulsivity according to several dimensions. The results indicate that borderline patients scored significantly higher than bipolar patients at the ALS and AIM scales. Regarding the UPPS, borderline patients scored significantly higher than bipolar patients for the dimensions "lack of premeditation" and "lack of perseverance"; however, bipolar patients had significantly higher scores than borderline patients for the dimension "negative emergency". This study shows that bipolar disorder and borderline personality can be differentiated thanks to emotional dimensions as well as different dimensions of impulsivity: borderline patients appear to have an affective lability and intensity more important than bipolar patients; it also appears that impulsivity manifests itself differently according to the disorder. Copyright © 2016 L'Encéphale, Paris. Published by Elsevier Masson SAS. All

  3. Clinical characteristics of impulse control and related disorders in Chinese Parkinson's disease patients.

    Science.gov (United States)

    Zhang, Yu; He, An Qi; Li, Lin; Chen, Wei; Liu, Zhen Guo

    2017-05-18

    Impulse control and related disorders (ICRDs) are clinically complications in Parkinson's disease (PD). However, the clinical characteristics of ICRDs in Chinese PD patients were rarely reported. We aimed to explore the prevalence and the clinical profile of ICRDs in Chinese patients with PD. 142 Chinese PD patients were consecutively enrolled. The symptoms of ICRDs were assessed with the Questionnaire for Impulsive-Compulsive Disorders. The clinical characteristics of patients with ICRDs and without ICRDs were compared. ICRDs were present in 31% of our patients. The most common ICRDs were compulsive medication use (11.3%) and punding (9.2%); the least frequent were walkabout (1.4%). Variables independently associated with ICRDs were earlier onset of the disease (≤55 years), severe cognitive impairment (MMSE 10-20), the dose of dopamine agonist (>1 mg/d) and dyskinesia. ICRDs was commonly found in Chinese PD patients. Earlier onset of the disease, the dose of dopamine agonist, severe cognitive impairment and dyskinesia are independent factors associated with ICRDs. Our results will be benefit for clinicians to assess the risk of developing ICRDs before delivering dopaminergic medication.

  4. Linking neuroscience with modern concepts of impulse control disorders in Parkinson’s disease

    Science.gov (United States)

    Napier, T. Celeste; Corvol, Jean-Christophe; Grace, Anthony A.; Roitman, Jamie D.; Rowe, James; Voon, Valerie; Strafella, Antonio P.

    2014-01-01

    Patients with Parkinson’s disease (PD) may experience impulse control disorders (ICDs) when on dopamine agonist therapy for their motor symptoms. In the last few years, there has been a rapid growth of interest for the recognition of these aberrant behaviors and their neurobiological correlates. Recent advances in neuroimaging are helping to identify the neuroanatomical networks responsible for these ICDs, and together with psychopharmacological assessments are providing new insights into the brain status of impulsive behavior. The genetic associations that may be unique to ICDs in PD are also being identified. Complementing human studies, electrophysiological and biochemical studies in animal models are providing insights into neuropathological mechanisms associated with these disorders. New animal models of ICDs in PD patients are being implemented that should provide critical means to identify efficacious therapies for PD-related motor deficits while avoiding ICD side effects. Here, we provide an overview of these recent advances, with a particular emphasis on the neurobiological correlates reported in animal models and patients along with their genetic underpinnings. PMID:25476402

  5. A Cueing Procedure To Control Impulsivity in Children with Attention Deficit Hyperactivity Disorder.

    Science.gov (United States)

    Posavac, Heidi D.; Sheridan, Susan M.; Posavac, Steven S.

    1999-01-01

    Tests the efficacy of a cueing procedure for improving the impulse regulation of four boys with Attention Deficit Hyperactivity Disorder (ADHD) during social skills training. Behavioral data suggested that all subjects demonstrated positive changes in impulse regulation. Likewise, the treatment effects appeared to have produced positive effects on…

  6. A Randomized Controlled Trial of a Novel Self-Help Technique for Impulse Control Disorders: A Study on Nail-Biting

    Science.gov (United States)

    Moritz, Steffen; Treszl, Andras; Rufer, Michael

    2011-01-01

    Nail-biting is currently classified as an impulse control disorder not otherwise specified. Although seldom targeted as a primary symptom, nail-biting is often associated with somatic complications and decreased quality of life. The present study assessed the effectiveness of an innovative self-help technique, titled decoupling (DC). DC aims at…

  7. Improving Inhibitory Control Abilities (ImpulsE)-A Promising Approach to Treat Impulsive Eating?

    Science.gov (United States)

    Preuss, Hanna; Pinnow, Marlies; Schnicker, Katja; Legenbauer, Tanja

    2017-11-01

    Although there is preliminary evidence that inhibitory control training improves impulsive eating, less is known about the effects on eating behaviour and weight loss in clinical samples. Sixty-nine treatment-seeking adults with obesity (binge-eating disorder 33.3%; other specific feeding and eating disorders 40.6%) were randomly blockwise allocated to ImpulsE, an intervention to improve inhibitory control and emotion regulation abilities or a guideline-appropriate cognitive behavioural therapy (CBT)-based treatment as usual. Self-reported and performance-based impulsivity, eating disorder pathology and BMI were compared at baseline (T1), post-treatment (T2) and 1- or 3-month follow-up. ImpulsE led to better food-specific inhibition performance (p = .004), but groups did not differ regarding improvements in global Eating Disorder Examination Questionnaire (EDE-Q) score at T2. At 3-month follow-up, binge eaters benefited most from ImpulsE (p = .028) and completers of ImpulsE demonstrated a significantly greater weight reduction (p = .030). The current findings propose ImpulsE as a promising approach to treat obesity, illustrating acceptability and additional benefits for course of weight. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

  8. The neurobiology of impulse control disorders in Parkinson's disease: from neurotransmitters to neural networks.

    Science.gov (United States)

    Vriend, Chris

    2018-01-30

    Impulse control disorders (ICD) are common neuropsychiatric disorders that can arise in Parkinson's disease (PD) patients after commencing dopamine replacement therapy. Approximately 15% of all patients develop these disorders and many more exhibit subclinical symptoms of impulsivity. ICD is thought to develop due to an interaction between the use of dopaminergic medication and an as yet unknown neurobiological vulnerability that either pre-existed before PD onset (possibly genetic) or is associated with neural alterations due to the PD pathology. This review discusses genes, neurotransmitters and neural networks that have been implicated in the pathophysiology of ICD in PD. Although dopamine and the related reward system have been the main focus of research, recently, studies have started to look beyond those systems to find new clues to the neurobiological underpinnings of ICD and come up with possible new targets for treatment. Studies on the whole-brain connectome to investigate the global alterations due to ICD development are currently lacking. In addition, there is a dire need for longitudinal studies that are able to disentangle the contributions of individual (genetic) traits and secondary effects of the PD pathology and chronic dopamine replacement therapy to the development of ICD in PD.

  9. The impact of comorbid impulsive/compulsive disorders in problematic Internet use.

    Science.gov (United States)

    Chamberlain, Samuel R; Ioannidis, Konstantinos; Grant, Jon E

    2018-05-23

    Background and aims Problematic Internet use (PIU) is commonplace but is not yet recognized as a formal mental disorder. Excessive Internet use could result from other conditions such as gambling disorder. The aim of the study was to assess the impact of impulsive-compulsive comorbidities on the presentation of PIU, defined using Young's Diagnostic Questionnaire. Methods A total of 123 adults aged 18-29 years were recruited using media advertisements, and attended the research center for a detailed psychiatric assessment, including interviews, completion of questionnaires, and neuropsychological testing. Participants were classified into three groups: PIU with no comorbid impulsive/compulsive disorders (n = 18), PIU with one or more comorbid impulsive/compulsive disorders (n = 37), and healthy controls who did not have any mental health diagnoses (n = 67). Differences between the three groups were characterized in terms of demographic, clinical, and cognitive variables. Effect sizes for overall effects of group were also reported. Results The three groups did not significantly differ on age, gender, levels of education, nicotine consumption, or alcohol use (small effect sizes). Quality of life was significantly impaired in PIU irrespective of whether or not individuals had comorbid impulsive/compulsive disorders (large effect size). However, impaired response inhibition and decision-making were only identified in PIU with impulsive/compulsive comorbidities (medium effect sizes). Discussion and conclusions Most people with PIU will have one or more other impulsive/compulsive disorders, but PIU can occur without such comorbidities and still present with impaired quality of life. Response inhibition and decision-making appear to be disproportionately impacted in the case of PIU comorbid with other impulsive/compulsive conditions, which may account for some of the inconsistencies in the existing literature. Large scale international collaborations are

  10. Poor Sleep and Its Relation to Impulsivity in Patients with Antisocial or Borderline Personality Disorders.

    Science.gov (United States)

    Van Veen, M M; Karsten, J; Lancel, M

    2017-01-01

    Studies investigating sleep and personality disorders consistently demonstrate a relation between personality disorders characterized by behavioral disinhibition and/or emotional dysregulation (traditionally termed cluster B personality disorders) and poor sleep. This finding is in line with previous studies associating insomnia with impulsive behavior, since this is a core characteristic of both antisocial and borderline personality disorder. The current study investigates a group (n = 112) of forensic psychiatric inpatients with antisocial or borderline personality disorder or traits thereof. Subjective sleep characteristics and impulsivity were assessed with the Pittsburgh Sleep Quality Index, the Sleep Diagnosis List, and the Barratt Impulsiveness Scale, respectively. More than half of the patients (53.6%) report poor sleep quality and 22.3% appears to suffer from severe chronic insomnia. Both poor sleep quality and chronic insomnia are significantly associated with self-reported impulsivity, in particular with attentional impulsiveness. This association was not significantly influenced by comorbid disorders. Actively treating sleep problems in these patients may not only improve sleep quality, mental health, and physical well-being, but may also have impact on impulsivity-related health risks by increasing self-control.

  11. Impulsivity in bipolar disorders in a Tunisian sample.

    Science.gov (United States)

    Feki, Ines; Moalla, Mariem; Baati, Imen; Trigui, Dorsaf; Sellami, Rim; Masmoudi, Jaweher

    2016-08-01

    Impulsivity as a trait characteristic is increased in bipolar disorder and may be a core factor of the illness. The objectives of our work are to evaluate the level of impulsivity among patients with bipolar disorder and to study its relation with mood state, alcohol misuse, suicide attempts and other socio-demographic and clinical factors. We measured impulsivity in 60 subjects with bipolar disorder in relationship to socio-demographic and clinical variables. The subjects completed Data included socio-demographic details and clinical variables, the Barratt Impulsiveness Scale (BIS-11) in an Arabic version to assess impulsivity, The Mini International Neuropsychiatric Interview "MINI" version 05 to screen for alcohol abuse or dependence and mood graphic rate scale (MGRS) to evaluate mood state. Our results show that the mean score of BIS-11 was 71.5. Fifty-five per cent of the patients had a high level of impulsiveness. No differences were found relating to mood state. Impulsivity was related to Male gender, lower educational level, early age of onset, smoking, alcohol and drug misuse and prior suicide attempts. The treatment of patients with BD should consider to reduce impulsivity to improve morbidity. Copyright © 2016 Elsevier B.V. All rights reserved.

  12. Pathological Gambling: Compulsive-Impulsive Spectrum Disorder, Behavioural Addiction, or Both?

    OpenAIRE

    Bottesi, Gioia

    2013-01-01

    Pathological gambling (PG) is a chronic and progressive condition, defined as “persistent and recurrent maladaptive gambling behaviour”; it is currently classified among the Impulse control disorders (Not Elsewhere Classified) in the Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition - Text Revision (DSM-IV-TR). The diagnostic criteria for PG resemble those of both Substance use disorders (SUDs) and Compulsive disorders (in particular, Obsessive compulsive disorder [OCD])....

  13. Psychosis and concurrent impulse control disorder in Parkinson's disease: A review based on a case report.

    Science.gov (United States)

    Guedes, Bruno Fukelmann; Gonçalves, Marcia Rubia; Cury, Rubens Gisbert

    2016-01-01

    Psychosis, impulse control disorders (e.g., pathological gambling and hypersexuality) and repetitive behaviors such as punding are known psychiatric complications of Parkinson's disease (PD). Impulsive, compulsive and repetitive behaviors are strongly associated with dopamine-replacement therapy. We present the case of a 58-year-old man with PD and a myriad of psychiatric symptoms. Concurrent psychosis, punding and pathological gambling developed more than six years after the introduction of pramipexole and ceased shortly after the addition of quetiapine and discontinuation of pramipexole. This report emphasizes the importance of monitoring for a wide array of psychiatric symptoms in patients on dopamine replacement therapy.

  14. Impulse control disorders in Parkinson's disease: clinical characteristics and implications.

    Science.gov (United States)

    Leeman, Robert F; Potenza, Marc N

    2011-04-01

    Impulse control disorders (ICDs), specifically those related to excessive gambling, eating, sex and shopping, have been observed in a subset of people with Parkinson's disease (PD). Although some initial case reports claimed that dopamine replacement therapies, particularly dopamine agonists, cause ICDs, more recent, larger and better controlled studies indicate a more complicated picture. While dopamine replacement therapy use is related to ICDs, other vulnerabilities, some related to PD and/or its treatment directly and others seemingly unrelated to PD, have also been associated with ICDs in PD. This suggests a complex etiology with multiple contributing factors. As ICDs occur in a sizable minority of PD patients and can be associated with significant distress and impairment, further investigation is needed to identify factors that can predict who may be more likely to develop ICDs. Clinical implications are discussed and topics for future research are offered.

  15. Anger, impulsivity, and anger control in combat-related posttraumatic stress disorder.

    Science.gov (United States)

    Chemtob, C M; Hamada, R S; Roitblat, H L; Muraoka, M Y

    1994-08-01

    Empirical evidence of a relationship between combat-related PTSD and increased anger is lacking. In this study, 24 veterans of the Vietnam War with posttraumatic stress disorder (PTSD) scored significantly higher on an Anger factor comprising multiple measures of anger than did comparison groups of 23 well-adjusted Vietnam combat veterans and 12 noncombat Vietnam-era veterans with psychiatric diagnoses. In contrast, the 3 groups did not differ significantly on orthogonal factors, one of which comprised cognitive impulsivity measures and the other of which reflected motor impulsivity. Changes in heart rate in response to provocation loaded positively on the Anger factor and negatively on the 2 Impulsivity factors. Concurrent depression and trait anxiety did not have an effect on level of anger in individuals with PTSD. These empirical findings support and extend the clinical evidence regarding PTSD and anger.

  16. Impulse control disorders in Parkinson's disease: a psychosocial perspective.

    Science.gov (United States)

    Delaney, Mary; Leroi, Iracema; Simpson, Jane; Overton, Paul Geoffrey

    2012-09-01

    Parkinson's disease (PD) is a progressive neurodegenerative disease primarily characterised by motor symptoms. However, another feature of PD which is receiving increasing attention is the phenomenon of impulse control disorders (ICDs), such as pathological gambling. To date, research into ICDs in PD has centred on a biomedical model of cause, related to the effects of dopamine replacement therapy. However, there are several areas of discrepancy in the current biomedical account of ICDs in PD. In addition, we argue that social and psychological factors also need to be considered to achieve a more complete understanding of the phenomenon. We present a novel conceptual model which combines biomedical and psychosocial factors in the genesis of ICDs in PD and use the model to identify a number of potential treatment intervention points and to highlight important outstanding questions concerning the inter-relationship between psychosocial and biomedical factors in the genesis of ICDs in PD.

  17. 'Impulsive compulsivity' in obsessive-compulsive disorder: a phenotypic marker of patients with poor clinical outcome.

    Science.gov (United States)

    Kashyap, Himani; Fontenelle, Leonardo F; Miguel, Euripedes C; Ferrão, Ygor A; Torres, Albina R; Shavitt, Roseli G; Ferreira-Garcia, Rafael; do Rosário, Maria C; Yücel, Murat

    2012-09-01

    Although traditionally obsessive-compulsive disorder (OCD) and impulse control disorders (ICD) have represented opposing ends of a continuum, recent research has demonstrated a frequent co-occurrence of impulsive and compulsive behaviours, which may contribute to a worse clinical picture of some psychiatric disorders. We hypothesize that individuals with 'impulsive' OCD as characterized by poor insight, low resistance, and reduced control towards their compulsions will have a deteriorative course, greater severity of hoarding and/or symmetry/ordering symptoms, and comorbid ICD and/or substance use disorders (SUD). The sample consisted of 869 individuals with a minimum score of 16 on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Of these, 65 had poor insight, low resistance, and reduced control towards compulsions ('poor IRC') and 444 had preserved insight, greater resistance and better control over compulsions ('good IRC'). These two groups were compared on a number of clinical and demographic variables. Individuals with poor IRC were significantly more likely to have a deteriorative course (p disorder (p = 0.026), trichotillomania (p = 0.014) and compulsive buying (p = 0.040). Regression analysis revealed that duration of obsessions (p = 0.037) and hoarding severity (p = 0.005) were significant predictors of poor IRC. In the absence of specific measures for impulsivity in OCD, the study highlights the utility of simple measures such as insight, resistance and control over compulsions as a phenotypic marker of a subgroup of OCD with impulsive features demonstrating poor clinical outcome. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Reduced dopamine transporter binding predates impulse control disorders in Parkinson's disease.

    Science.gov (United States)

    Vriend, Chris; Nordbeck, Anna H; Booij, Jan; van der Werf, Ysbrand D; Pattij, Tommy; Voorn, Pieter; Raijmakers, Pieter; Foncke, Elisabeth M J; van de Giessen, Elsmarieke; Berendse, Henk W; van den Heuvel, Odile A

    2014-06-01

    Impulse control disorders (ICD) are relatively common in Parkinson's disease (PD) and generally are regarded as adverse effects of dopamine replacement therapy, although certain demographic and clinical risk factors are also involved. Previous single-photon emission computed tomography (SPECT) studies showed reduced ventral striatal dopamine transporter binding in Parkinson patients with ICD compared with patients without. Nevertheless, these studies were performed in patients with preexisting impulse control impairments, which impedes clear-cut interpretation of these findings. We retrospectively procured follow-up data from 31 medication-naïve PD patients who underwent dopamine transporter SPECT imaging at baseline and were subsequently treated with dopamine replacement therapy. We used questionnaires and a telephone interview to assess medication status and ICD symptom development during the follow-up period (31.5 ± 12.0 months). Eleven patients developed ICD symptoms during the follow-up period, eight of which were taking dopamine agonists. The PD patients with ICD symptoms at follow-up had higher baseline depressive scores and lower baseline dopamine transporter availability in the right ventral striatum, anterior-dorsal striatum, and posterior putamen compared with PD patients without ICD symptoms. No baseline between-group differences in age and disease stage or duration were found. The ICD symptom severity correlated negatively with baseline dopamine transporter availability in the right ventral and anterior-dorsal striatum. The results of this preliminary study show that reduced striatal dopamine transporter availability predates the development of ICD symptoms after dopamine replacement therapy and may constitute a neurobiological risk factor related to a lower premorbid dopamine transporter availability or a more pronounced dopamine denervation in PD patients susceptible to ICD. © 2014 International Parkinson and Movement Disorder Society.

  19. A Multicenter Comparative Study of Impulse Control Disorder in Latin American Patients With Parkinson Disease.

    Science.gov (United States)

    Ramírez Gómez, Carolina Candelaria; Serrano Dueñas, Marcos; Bernal, Oscar; Araoz, Natalia; Sáenz Farret, Michel; Aldinio, Victoria; Montilla, Verónica; Micheli, Federico

    Impulse control disorder (ICD) is a common adverse effect in patients with Parkinson disease who receive dopamine agonists; however, other factors are involved in its manifestations. To study the frequency and factors involved in the development of this adverse effect in a Latin American population, we conducted a cross-sectional multicenter study. Two hundred fifty-five patients in 3 Latin American centers were evaluated by examination and application of scales (Unified Parkinson's Disease Rating Scale, Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale, Hoehn and Yahr, Clinical Impression of Severity Index for Parkinson's Disease). Of the patients, 27.4% had ICD, most of whom were on dopamine agonists. Other associated risk factors included a younger age at onset of Parkinson disease, moderate symptoms, a shorter evolution of the clinical manifestations, rapid eye movement (REM) sleep disorder behavior, and the consumption of tea, mate, and alcohol. The frequency of ICD is higher in Latin America than in Anglo-Saxon populations. Consuming tea and mate, in addition to the use of dopamine agonists, is a factor that may demonstrate a genetic link that predisposes patients to the establishment of an ICD.

  20. [The relationship of attachment features and multi-impulsive symptoms in eating disorders].

    Science.gov (United States)

    Szalai, Tamás Dömötör

    2017-07-01

    Attachment dysfunctions determine borderline personality disorder, which is a frequent background factor of multi-impulsivity; however, the relationship between attachment and multi-impulsive eating disorders is almost unexplored. To compare attachment features of multi-impulsive and classical eating disorder patients with individuals without eating disorders, and to test attachment as a predictor of multi-impulsivity. A cross-sectional survey (148 females, mean age: 30.9 years) investigated maternal, paternal and adult attachment, depression, anxiety, eating disorder and multi-impulsive symptoms in these groups. Altogether 41.3% of the individuals without eating disorders, 17.6% of classical and 11.8% of multi-impulsive eating disorder patients had secure attachment. Multi-impulsive patients had the most severe eating disorder symptoms (F (2) = 17.733) and the lowest paternal care (F (2) = 3.443). Preoccupied and fearful attachment explained 14.5% of multi-impulsive symptoms; however, with adjustment for depression only latter one remained the predictor of multi-impulsivity (t = 5.166, peating disorder patients from the aspects of both symptoms and attachment. Handling their negative moods may hold therapeutic potentials. Longitudinal studies are required to investigate the therapeutic value of paternal care, attachment preoccupation and fearfulness. Orv Hetil. 2017; 158(27): 1058-1066.

  1. Psychosis and concurrent impulse control disorder in Parkinson's disease: A review based on a case report

    Directory of Open Access Journals (Sweden)

    Bruno Fukelmann Guedes

    Full Text Available ABSTRACT Psychosis, impulse control disorders (e.g., pathological gambling and hypersexuality and repetitive behaviors such as punding are known psychiatric complications of Parkinson's disease (PD. Impulsive, compulsive and repetitive behaviors are strongly associated with dopamine-replacement therapy. We present the case of a 58-year-old man with PD and a myriad of psychiatric symptoms. Concurrent psychosis, punding and pathological gambling developed more than six years after the introduction of pramipexole and ceased shortly after the addition of quetiapine and discontinuation of pramipexole. This report emphasizes the importance of monitoring for a wide array of psychiatric symptoms in patients on dopamine replacement therapy.

  2. Impulsivity-focused group intervention to reduce binge eating episodes in patients with binge eating disorder: study protocol of the randomised controlled IMPULS trial

    OpenAIRE

    Schag, Kathrin; Leehr, Elisabeth J; Martus, Peter; Bethge, Wolfgang; Becker, Sandra; Zipfel, Stephan; Giel, Katrin E

    2015-01-01

    Introduction The core symptom of binge eating disorder (BED) is recurrent binge eating that is accompanied by a sense of loss of control. BED is frequently associated with obesity, one of the main public health challenges today. Experimental studies deliver evidence that general trait impulsivity and disorder-specific food-related impulsivity constitute risk factors for BED. Cognitive-behavioural treatment (CBT) is deemed to be the most effective intervention concerning BED. We developed a gr...

  3. [Hypersexuality and other impulse control disorders in Parkinson's disease].

    Science.gov (United States)

    Nelis, Elise A; Berendse, Henk W; van den Heuvel, Odile A

    2016-01-01

    Impulse control disorders (ICD) in Parkinson's disease (PD) pose a therapeutic challenge. This article provides a description of the symptoms and management strategies of ICD in PD. We present two men aged 52 and 69 with ICD, especially hypersexuality, in response to dopaminergic medication. In the first case the symptoms of hypersexuality and gambling decreased after reducing the dose of the dopamine-agonist. In the second case the hypersexuality symptoms decreased after addition of naltrexon. It is important to recognize the symptoms of ICD in PD because of the large impact on social and relational functioning. It is of great importance to repeatedly ask the patient and their partner about these symptoms, since feelings of shame and guild hamper spontaneous report. The first step of treatment consists of reducing the dose of dopaminergic medication and/or to switch from dopamine-agonist to levodopa. Although the research on effective treatment options has been limited so far, treatment alternatives from the addiction field seem promising.

  4. Social phobia as a comorbid condition in sex offenders with paraphilia or impulse control disorder.

    Science.gov (United States)

    Hoyer, J; Kunst, H; Schmidt, A

    2001-07-01

    Studies on the prevalence of social anxiety in sex offenders show mixed results. This may be due to social anxiety being heightened only in diagnostic subgroups of sex offenders, namely in paraphiliacs. In study 1, 72 mentally disordered sexual delinquents and 30 controls were screened for social anxiety with the Social Interaction Anxiety Scale and the Social Phobia Scale by Mattick and Clarke (German versions). In study 2, 55 mentally disordered sexual delinquents were diagnosed with a structured clinical interview. In both studies, sex offenders were categorized as either paraphilic or impulse control disordered (without paraphilia) according to research criteria. Study 1 showed markedly heightened scores for social anxiety in paraphiliacs, particularly for social interaction anxiety. Study 2 found a high lifetime and point prevalence of social phobia in paraphiliacs for which corroborating evidence was again found in questionnaire results. Implications for further research, diagnostic procedures, and therapy are discussed.

  5. IMPULSIVE-COMPULSIVE DISORDERS IN PARKINSON'S DISEASE. CLINICAL CASES

    Directory of Open Access Journals (Sweden)

    N. V. Fedorova

    2015-01-01

    ­compulsive disorders piribedil was replaced with pramipexole 1.5 mg prolonged form one time a day. At the control examination after 3 months behavioral disorders completely regressed.Conclusion. This article describes two clinical cases of impulsive­compulsive disorders in patients with Parkinson s disease, methods of di­ agnosis and correction capabilities of these disorders

  6. A negative relationship between ventral striatal loss anticipation response and impulsivity in borderline personality disorder

    OpenAIRE

    Herbort, Maike C.; Soch, Joram; W?stenberg, Torsten; Krauel, Kerstin; Pujara, Maia; Koenigs, Michael; Gallinat, J?rgen; Walter, Henrik; Roepke, Stefan; Schott, Bj?rn H.

    2016-01-01

    Patients with borderline personality disorder (BPD) frequently exhibit impulsive behavior, and self-reported impulsivity is typically higher in BPD patients when compared to healthy controls. Previous functional neuroimaging studies have suggested a link between impulsivity, the ventral striatal response to reward anticipation, and prediction errors. Here we investigated the striatal neural response to monetary gain and loss anticipation and their relationship with impulsivity in 21 female BP...

  7. Impulsivity-focused group intervention to reduce binge eating episodes in patients with binge eating disorder: study protocol of the randomised controlled IMPULS trial.

    Science.gov (United States)

    Schag, Kathrin; Leehr, Elisabeth J; Martus, Peter; Bethge, Wolfgang; Becker, Sandra; Zipfel, Stephan; Giel, Katrin E

    2015-12-18

    The core symptom of binge eating disorder (BED) is recurrent binge eating that is accompanied by a sense of loss of control. BED is frequently associated with obesity, one of the main public health challenges today. Experimental studies deliver evidence that general trait impulsivity and disorder-specific food-related impulsivity constitute risk factors for BED. Cognitive-behavioural treatment (CBT) is deemed to be the most effective intervention concerning BED. We developed a group intervention based on CBT and especially focusing on impulsivity. We hypothesise that such an impulsivity-focused group intervention is able to increase control over impulsive eating behaviour, that is, reduce binge eating episodes, further eating pathology and impulsivity. Body weight might also be influenced in the long term. The present randomised controlled trial investigates the feasibility, acceptance and efficacy of this impulsivity-focused group intervention in patients with BED. We compare 39 patients with BED in the experimental group to 39 patients with BED in the control group at three appointments: before and after the group intervention and in a 3-month follow-up. Patients with BED in the experimental group receive 8 weekly sessions of the impulsivity-focused group intervention with 5-6 patients per group. Patients with BED in the control group receive no group intervention. The primary outcome is the binge eating frequency over the past 4 weeks. Secondary outcomes comprise further eating pathology, general impulsivity and food-related impulsivity assessed by eye tracking methodology, and body weight. Additionally, we assess binge eating and other impulsive behaviour weekly in process analyses during the time period of the group intervention. This study has been approved by the ethics committee of the medical faculty of Eberhard Karls University Tübingen and the University Hospital Tübingen. Data are monitored by the Centre of Clinical Studies, University Hospital T

  8. Relationship between anhedonia and impulsivity in schizophrenia, major depression and schizoaffective disorder.

    Science.gov (United States)

    Amr, Mostafa; Volpe, Fernando Madalena

    2013-12-01

    Anhedonia and impulsivity are prominent symptoms of many psychiatric disorders and may indicate worse prognosis, notably in schizophrenia and major depression. Despite the convergence of negative outcomes from both dimensions, the relationship between anhedonia and impulsivity in psychiatric disorders has been seldom directly assessed. The objective of the present study is to examine the correlations between anhedonia and impulsivity in three diagnostic groups: major depression, schizophrenia and schizoaffective disorder. 121 outpatients (Mansoura University Hospital, Egypt) with major depressive disorder (N=29), schizophrenia (N=59), and schizoaffective disorder (N=33), were assessed and responded to the Beck Depression Inventory, Barrat's Impulsivity Scale-11, and Chapman's Social and Physical Anhedonia Scales. Physical and social anhedonia scores were negatively correlated to impulsivity scores in major depression patients. Conversely, higher scores in physical and social anhedonia predicted higher impulsivity scores in schizophrenia. No correlations between impulsivity and anhedonia were evidenced among schizoaffectives. The relationship between self-reported physical and social anhedonia and impulsivity is diagnosis-specific. Copyright © 2013 Elsevier B.V. All rights reserved.

  9. Antisocial personality and bipolar disorder: interactions in impulsivity and course of illness

    Science.gov (United States)

    Swann, Alan C

    2011-01-01

    SUMMARY Antisocial personality disorder (ASPD) and bipolar disorder are both characterized by impulsive behavior, increased incarceration or arrest, addictive disorders and suicidal behavior. These characteristics appear more severe in the combined disorders. Individuals with ASPD who also have bipolar disorder have higher rates of addictive disorders and suicidal behavior and are more impulsive, as measured by questionnaires or behavioral laboratory tests. Those with bipolar disorder who have ASPD have higher rates of addictive, criminal and suicidal behavior, earlier onset of bipolar disorder with a more recurrent and predominately manic course and increased laboratory-measured, but not questionnaire-rated, impulsivity. These characteristics may result in part from differential impulsivity mechanisms in the two disorders, with bipolar disorder driven more by excessive catecholamine sensitivity and ASPD by deficient serotonergic function. PMID:22235235

  10. Impaired learning of punishments in Parkinson's disease with and without impulse control disorder.

    Science.gov (United States)

    Leplow, Bernd; Sepke, Maria; Schönfeld, Robby; Pohl, Johannes; Oelsner, Henriette; Latzko, Lea; Ebersbach, Georg

    2017-02-01

    To document specific learning mechanisms in patients with Parkinson's disease (PD) with and without impulse control disorder (ICD). Thirty-two PD patients receiving dopamine replacement therapy (DRT) were investigated. Sixteen were diagnosed with ICD (ICD + ) and 16 PD patients matched for levodopa equivalence dosage, and DRT duration and severity of disease did not show impulsive behavior (non-ICD). Short-term learning of inhibitory control was assessed by an experimental procedure which was intended to mimic everyday life. Correct inhibition especially, had to be learned without reward (passive avoidance), and the failure to inhibit a response was punished (punishment learning). Results were compared to 16 healthy controls (HC) matched for age and sex. In ICD + patients within-session learning of non-rewarded inhibition was at chance levels. Whereas healthy controls rapidly developed behavioral inhibition, non-ICD patients were also significantly impaired compared to HC, but gradually developed some degree of control. Both patient groups showed significantly decreased learning if the failure to withhold a response was punished. PD patients receiving DRT show impaired ability to acquire both punishment learning and passive avoidance learning, irrespective of whether or not ICD was developed. In ICD + PD patients, behavioral inhibition is nearly absent. Results demonstrate that by means of subtle learning paradigms it is possible to identify PD-DRT patients who show subtle alterations of punishment learning. This may be a behavioral measure for the identification of PD patients who are prone to develop ICD if DRT is continued.

  11. Relationship between 5-HT function and impulsivity and aggression in male offenders with personality disorders

    OpenAIRE

    Dolan, M; Anderson, I M; Deakin, J F

    2001-01-01

    BACKGROUND: Reduced serotonergic (5-HT) function and elevated testosterone have been reported in aggressive populations.AIMS: To investigate relationships between impulsivity, aggression, 5-HT function and testosterone in male offenders with personality disorders.METHOD: Sixty male offenders with DSM-III-R personality disorders and 27 healthy staff controls were assessed using the Special Hospital Assessment of Personality and Socialisation (SHAPS), impulsivity and aggression ratings, d-fenfl...

  12. Antisocial personality disorder and borderline symptoms are differentially related to impulsivity and course of illness in bipolar disorder.

    Science.gov (United States)

    Swann, Alan C; Lijffijt, Marijn; Lane, Scott D; Steinberg, Joel L; Moeller, F Gerard

    2013-06-01

    Interactions between characteristics of bipolar and Axis II cluster B disorders are clinically and diagnostically challenging. Characteristics associated with personality disorders may be dimensional aspects of bipolar disorder. We investigated relationships among antisocial personality disorder (ASPD) or borderline personality disorder symptoms, impulsivity, and course of illness in bipolar disorder. Subjects with bipolar disorder were recruited from the community. Diagnosis was by structured clinical interview for DSM-IV (SCID-I and -II), psychiatric symptom assessment by the change version of the schedule for affective disorders and schizophrenia (SADS-C), severity of Axis II symptoms by ASPD and borderline personality disorder SCID-II symptoms, and impulsivity by the Barratt impulsiveness scale (BIS-11). ASPD and borderline symptoms were not related to clinical state or affective symptoms. Borderline symptoms correlated with BIS-11 impulsivity scores, and predicted history of suicide attempts independently of the relationship to impulsivity. ASPD symptoms were more strongly related to course of illness, including early onset, frequent episodes, and substance-related disorders. These effects persisted after allowance for gender and substance-use disorder history. Personality disorder symptoms appear to be dimensional, trait-like characteristics of bipolar disorder. ASPD and Borderline symptoms are differentially related to impulsivity and course of illness. Copyright © 2012 Elsevier B.V. All rights reserved.

  13. Antisocial Personality Disorder and Borderline Symptoms are Differentially Related to Impulsivity and Course of Illness in Bipolar Disorder

    Science.gov (United States)

    Swann, Alan C.; Lijffijt, Marijn; Lane, Scott D.; Steinberg, Joel L.; Moeller, F. Gerard

    2012-01-01

    Background Interactions between characteristics of bipolar and Axis II cluster B disorders are clinically and diagnostically challenging. Characteristics associated with personality disorders may be dimensional aspects of bipolar disorder. We investigated relationships among antisocial personality disorder (ASPD) or borderline personality disorder symptoms, impulsivity, and course of illness in bipolar disorder. Methods Subjects with bipolar disorder were recruited from the community. Diagnosis was by Structured Clinical Interview for DSM-IV (SCID-I and –II), psychiatric symptom assessment by the Change version of the Schedule for Affective Disorders and Schizophrenia (SADS-C), severity of axis II symptoms by ASPD and borderline personality disorder SCID-II symptoms, and impulsivity by the Barratt Impulsiveness Scale (BIS-11). Results ASPD and borderline symptoms were not related to clinical state or affective symptoms. Borderline symptoms correlated with BIS-11 impulsivity scores, and predicted history of suicide attempts independently of the relationship to impulsivity. ASPD symptoms were more strongly related to course of illness, including early onset, frequent episodes, and substance-related disorders. These effects persisted after allowance for gender and substance-use disorder history. Conclusions Personality disorder symptoms appear to be dimensional, trait-like characteristics of bipolar disorder. ASPD and Borderline symptoms are differentially related to impulsivity and course of illness. PMID:22835849

  14. Classifying hypersexual disorders: compulsive, impulsive, and addictive models.

    Science.gov (United States)

    Stein, Dan J

    2008-12-01

    In closing, we argue for two conclusions. First, there are advantages to using theoretically neutral terms (such as hypersexual disorder) that go beyond the compulsive-impulsive-addictive distinctions. Although the notion of theory-neutral observation cannot be defended, it is important not to rely on any particular theoretical framework before all the evidence is in. Our current nosology employs a range of contradictory terms and frameworks (eg, impulse control disorder, compulsive gambling and buying, trichotillomania, and kleptomania). In keeping with the approach taken in other DSM categories, it may be useful to find a more theory-neutral term that can cut across these conditions. Second, any conclusions drawn here about the nosology of hypersexual disorder must be tempered by the relative lack of rigorous psychobiological and systematic treatment data. A better understanding of the psychobiology of hypersexual disorder might provide greater confidence in one or the other theoretical model. The A-B-C model proposed here is tentative at best, given the relative absence of supporting data. Further, a richer assessment and treatment literature would allow clearer conclusions about the clinical utility of different nosological approaches. We emphasize the need for much additional work to characterize the phenomenology and psychobiology of hypersexual disorder and other conditions characterized by affective dysregulation, behavioral addiction, and cognitive dyscontrol, in the hope that such research would ultimately lead to improved assessment and management.

  15. Transdermal rotigotine causes impulse control disorders in patients with restless legs syndrome.

    Science.gov (United States)

    Schreglmann, S R; Gantenbein, A R; Eisele, G; Baumann, C R

    2012-02-01

    Dopaminergic drugs are the mainstay of treatment for restless legs syndrome (RLS). We analyzed the frequency and clinical characteristics of impulse control disorders (ICD) in patients with RLS on transdermal rotigotine treatment. Retrospective case series at a university movement disorder clinic (n = 28, 17 women). Symptoms of ICD were assessed via detailed history taking and scoring with the Zurich Screening Questionnaire for ICD (ZICD) prior to and after initiation of treatment. None of the patients had a history of ICD prior to treatment. Baseline mean scores for patients who did (8.0 ± 2.5) and did not (6.2 ± 2.7) develop ICD under treatment did not differ. Six male patients (21%) developed various symptoms of ICD (mean ZICD scores 20.7 ± 10.2) on rotigotine treatment (mean dose: 3.8 mg/d), including binge eating, hypersexuality, compulsive shopping, pathological gambling, and punding, equaling a prevalence rate of 21%. Also in the non-ICD group, ZICD scores increased (7.5 ± 2.8). This is the first report of ICD in patients treated with transdermal rotigotine for RLS. In contrast to literature, even low doses of rotigotine (mean 3.8 mg/d) can cause ICD. Therefore every prescribing physician should be aware that ICD may emerge in both RLS and PD patients on any dopaminergic treatment, and should actively ask for such symptoms. The ZICD questionnaire not only replicated the findings of detailed history taking but also showed an increased tendency towards impulsive behaviour in subjects that did not develop ICD. Copyright © 2011 Elsevier Ltd. All rights reserved.

  16. Neither bipolar nor obsessive-compulsive disorder: compulsive buyers are impulsive acquirers.

    Science.gov (United States)

    Filomensky, Tatiana Zambrano; Almeida, Karla Mathias; Castro Nogueira, Marcelo Campos; Diniz, Juliana Belo; Lafer, Beny; Borcato, Sonia; Tavares, Hermano

    2012-07-01

    Compulsive buying (CB) is currently classified as an impulse control disorder (ICD) not otherwise classified. Compulsive buying prevalence is estimated at around 5% of the general population. There is controversy about whether CB should be classified as an ICD, a subsyndromal bipolar disorder (BD), or an obsessive-compulsive disorder (OCD) akin to a hoarding syndrome. To further investigate the appropriate classification of CB, we compared patients with CB, BD, and OCD for impulsivity, affective instability, hoarding, and other OCD symptoms. Eighty outpatients (24 CB, 21 BD, and 35 OCD) who were neither manic nor hypomanic were asked to fill out self-report questionnaires. Compulsive buying patients scored significantly higher on all impulsivity measures and on acquisition but not on the hoarding subdimensions of clutter and "difficulty discarding." Patients with BD scored higher on the mania dimension from the Structured Clinical Interview for Mood Spectrum scale. Patients with OCD scored higher on obsessive-compulsive symptoms and, particularly, higher on the contamination/washing and checking dimensions from the Padua Inventory; however, they did not score higher on any hoarding dimension. A discriminant model built with these variables correctly classified patients with CB (79%), BD (71%), and OCD (77%). Patients with CB came out as impulsive acquirers, resembling ICD- rather than BD- or OCD-related disorders. Manic symptoms were distinctive of patients with BD. Hoarding symptoms other than acquisition were not particularly associated with any diagnostic group. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. Think twice: Impulsivity and decision making in obsessive-compulsive disorder.

    Science.gov (United States)

    Grassi, Giacomo; Pallanti, Stefano; Righi, Lorenzo; Figee, Martijn; Mantione, Mariska; Denys, Damiaan; Piccagliani, Daniele; Rossi, Alessandro; Stratta, Paolo

    2015-12-01

    Recent studies have challenged the anxiety-avoidance model of obsessive-compulsive disorder (OCD), linking OCD to impulsivity, risky-decision-making and reward-system dysfunction, which can also be found in addiction and might support the conceptualization of OCD as a behavioral addiction. Here, we conducted an exploratory investigation of the behavioral addiction model of OCD by assessing whether OCD patients are more impulsive, have impaired decision-making, and biased probabilistic reasoning, three core dimensions of addiction, in a sample of OCD patients and healthy controls. We assessed these dimensions on 38 OCD patients and 39 healthy controls with the Barratt Impulsiveness Scale (BIS-11), the Iowa Gambling Task (IGT) and the Beads Task. OCD patients had significantly higher BIS-11 scores than controls, in particular on the cognitive subscales. They performed significantly worse than controls on the IGT preferring immediate reward despite negative future consequences, and did not learn from losses. Finally, OCD patients demonstrated biased probabilistic reasoning as reflected by significantly fewer draws to decision than controls on the Beads Task. OCD patients are more impulsive than controls and demonstrate risky decision-making and biased probabilistic reasoning. These results might suggest that other conceptualizations of OCD, such as the behavioral addiction model, may be more suitable than the anxiety-avoidance one. However, further studies directly comparing OCD and behavioral addiction patients are needed in order to scrutinize this model.

  18. Resting-state brain networks in patients with Parkinson's disease and impulse control disorders.

    Science.gov (United States)

    Tessitore, Alessandro; Santangelo, Gabriella; De Micco, Rosa; Giordano, Alfonso; Raimo, Simona; Amboni, Marianna; Esposito, Fabrizio; Barone, Paolo; Tedeschi, Gioacchino; Vitale, Carmine

    2017-09-01

    To investigate intrinsic neural networks connectivity changes in Parkinson's disease (PD) patients with and without impulse control disorders (ICD). Fifteen patients with PD with ICD (ICD+), 15 patients with PD without ICD (ICD-) and 24 age and sex-matched healthy controls (HC) were enrolled in the study. To identify patients with and without ICD and/or punding, we used the Minnesota Impulsive Disorders Interview (MIDI) and a clinical interview based on diagnostic criteria for each symptom. All patients underwent a detailed neuropsychological evaluation. Whole brain structural and functional imaging was performed on a 3T GE MR scanner. Statistical analysis of functional data was completed using BrainVoyager QX software. Voxel-based morphometry (VBM) was used to test whether between-group differences in resting-state connectivity were related to structural abnormalities. The presence of ICD symptoms was associated with an increased connectivity within the salience and default-mode networks, as well as with a decreased connectivity within the central executive network (p < .05 corrected). ICD severity was correlated with both salience and default mode networks connectivity changes only in the ICD+ group. VBM analysis did not reveal any statistically significant differences in local grey matter volume between ICD+ and ICD- patients and between all patients and HC (p < .05. FWE). The presence of a disrupted connectivity within the three core neurocognitive networks may be considered as a potential neural correlate of ICD presence in patients with PD. Our findings provide additional insights into the mechanisms underlying ICD in PD, confirming the crucial role of an abnormal prefrontal-limbic-striatal homeostasis in their development. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Sleep and REM sleep behaviour disorder in Parkinson's disease with impulse control disorder.

    Science.gov (United States)

    Fantini, Maria Livia; Figorilli, Michela; Arnulf, Isabelle; Zibetti, Maurizio; Pereira, Bruno; Beudin, Patricia; Puligheddu, Monica; Cormier-Dequaire, Florence; Lacomblez, Lucette; Benchetrit, Eve; Corvol, Jean Christophe; Cicolin, Alessandro; Lopiano, Leonardo; Marques, Ana; Durif, Franck

    2018-03-01

    Because the association between rapid eye movement sleep behaviour disorder (RBD) and impulse control disorders (ICDs) in Parkinson's disease (PD) has been debated, we assessed the sleep characteristics and the frequency of RBD using video-polysomnography (v-PSG) in patients with PD with versus without ICDs. Eighty non-demented patients with PD consecutively identified during routine evaluation at three movement disorders centres were enrolled in a case-control study. Forty patients (22 men; mean age: 62.6±9.7 years, Hoehn & Yahr: 2.1±0.6) with one or more current ICDs were age-matched and sex-matched with 40 patients with no history of ICDs (22 men, mean age: 64.9±7.8 years, Hoehn & Yahr: 2.2±0.6). They underwent a detailed sleep interview followed by a full-night in-lab v-PSG. Sleep was scored blindly to ICDs condition and RBD diagnosis included a clinical complaint of enacted dreams and/or documented behaviour during rapid eye movement (REM) sleep, with the presence of quantified REM sleep without atonia (RSWA). Patients with ICDs had a higher arousal index and higher RSWA than those without ICDs (51.9%±28.2%vs 32.2±27.1%, p=0.004). In addition, RBD was more frequent in the ICD group (85%vs53%, p=0.0001). RBD was still associated with ICDs in a multivariate regression analysis including age of onset, PD duration and severity, treatment duration, levodopa-equivalent and dopamine agonist-equivalent daily doses and antidepressant use (OR: 4.9 (95% CI 1.3 to 18.5), p=0.02). This large, controlled series of patients with PD with ICDs assessed by v-PSG confirms the association between ICDs and RBD. Increased surveillance of symptoms of ICDs should be recommended in patients with PD with RBD. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  20. Trait and state impulsivity in males with tendency towards Internet-pornography-use disorder.

    Science.gov (United States)

    Antons, Stephanie; Brand, Matthias

    2018-04-01

    Impulsivity has been identified to be involved in the development and maintenance of specific Internet-use disorders (IUD). It can be differentiated between relatively stable trait impulsivity and state impulsivity which is dependent on environmental and affective factors such as craving. Following the I-PACE (Interaction of Person-Affect-Cognition-Execution) model, both trait and state impulsivity may play an interactive role in IUD. The present study aimed to investigate the relationship between trait and state impulsivity and symptom severity of Internet-pornography-use disorder (IPD) as one form of IUD. Fifty heterosexual males participated in this study. State impulsivity was measured with reaction times in a modified stop-signal task. Each participant conducted two blocks of this task which included neutral and pornographic pictures. Moreover, current subjective craving, trait impulsivity, and symptom severity of IPD were assessed using several questionnaires. Results indicate that trait impulsivity was associated with higher symptom severity of IPD. Especially those males with higher trait impulsivity and state impulsivity in the pornographic condition of the stop-signal task as well as those with high craving reactions showed severe symptoms of IPD. The results indicate that both trait and state impulsivity play a crucial role in the development of IPD. In accordance with dual-process models of addiction, the results may be indicative of an imbalance between the impulsive and reflective systems which might be triggered by pornographic material. This may result in loss of control over the Internet-pornography use albeit experiencing negative consequences. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Overlapping and disease specific trait, response, and reflection impulsivity in adolescents with first-episode schizophrenia spectrum disorders or attention-deficit/hyperactivity disorder

    DEFF Research Database (Denmark)

    Jepsen, J. R.M.; Rydkjaer, J.; Fagerlund, B.

    2018-01-01

    and Schizophrenia for School-aged Children – Present and Lifetime Version. Subjects with early-onset, first-episode schizophrenia spectrum disorders (EOS) (N = 29) or ADHD (N = 29) and healthy controls (N = 45) were compared on two performance measures (Information Sampling Task, Stop Signal Task) and a subjective......Background: Schizophrenia and attention-deficit/hyperactivity disorder (ADHD) are developmental disorders with shared clinical characteristics such as cognitive impairments and impulsivity. Impulsivity is a core feature of ADHD and an important factor in aggression, violence, and substance use...... in schizophrenia. Based on the hypothesis that schizophrenia and ADHD represent a continuum of neurodevelopmental impairments, the aim was to identify overlapping and disease specific forms of impulsivity. Methods: Adolescents between 12 and 17 years of age were assessed with the Schedule for Affective Disorders...

  2. [Impulsivity-focused Group Intervention to reduce Binge Eating Episodes in Patients with Binge Eating Disorder - A Group Training Program].

    Science.gov (United States)

    Schag, Kathrin; Leehr, Elisabeth J; Skoda, Eva-Maria; Becker, Sandra; Zipfel, Stephan; Giel, Katrin E

    2016-11-01

    Binge Eating Disorder (BED) is an eating disorder where cognitive behavioural therapy (CBT) could already show reliable efficacy. Relying on basic research, CBT interventions which especially focus on impulsivity could be effective, because binge eating episodes represent highly impulsive eating behaviour. For this reason, we developed a treatment concept about an impulsivity-focused behavioural group intervention for patients with BED, called IMPULS. The efficacy of IMPULS is currently investigated in a randomised controlled trial 1. IMPULS is drafted as a weekly group training programme with 5-6 participants per group. The essential interventions are food-related cue exposure with response prevention and the development of self-control strategies. These interventions are adapted onto the impulsivity concept from conventional treatment of addictive disorders and BED. © Georg Thieme Verlag KG Stuttgart · New York.

  3. Overlapping and disease specific trait, response, and reflection impulsivity in adolescents with first-episode schizophrenia spectrum disorders or attention-deficit/hyperactivity disorder.

    Science.gov (United States)

    Jepsen, J R M; Rydkjaer, J; Fagerlund, B; Pagsberg, A K; Jespersen, R Av F; Glenthøj, B Y; Oranje, B

    2018-03-01

    Schizophrenia and attention-deficit/hyperactivity disorder (ADHD) are developmental disorders with shared clinical characteristics such as cognitive impairments and impulsivity. Impulsivity is a core feature of ADHD and an important factor in aggression, violence, and substance use in schizophrenia. Based on the hypothesis that schizophrenia and ADHD represent a continuum of neurodevelopmental impairments, the aim was to identify overlapping and disease specific forms of impulsivity. Adolescents between 12 and 17 years of age were assessed with the Schedule for Affective Disorders and Schizophrenia for School-aged Children - Present and Lifetime Version. Subjects with early-onset, first-episode schizophrenia spectrum disorders (EOS) (N = 29) or ADHD (N = 29) and healthy controls (N = 45) were compared on two performance measures (Information Sampling Task, Stop Signal Task) and a subjective personality trait measure of impulsivity (Barratt Impulsiveness Scale, Version 11 (BIS-11)). Significantly increased reflection impulsivity was observed in ADHD but not in the EOS group. No significant response inhibition deficits (stop signal reaction time) were found in the two clinical groups. The ADHD and the EOS group showed significantly increased motor, attentional, and non-planning subtraits of impulsivity. Impaired pre-decisional information gathering appeared to be specific for ADHD while the information gathering was not significantly reduced in subjects with EOS. Neither the ADHD nor EOS group showed impaired response inhibition but shared increased personality subtraits of attentional, non-planning, and motor impulsivity although the latter was significantly more pronounced in ADHD. These increased subtraits of impulsivity may reflect diagnostic non-specific neurodevelopmental impairments in ADHD and EOS in adolescence.

  4. Morphometric changes in the reward system of Parkinson's disease patients with impulse control disorders.

    Science.gov (United States)

    Pellicano, Clelia; Niccolini, Flavia; Wu, Kit; O'Sullivan, Sean S; Lawrence, Andrew D; Lees, Andrew J; Piccini, Paola; Politis, Marios

    2015-12-01

    Impulse control disorders (ICDs) occur in a subset of patients with Parkinson's disease (PD) who are receiving dopamine replacement therapy. In this study, we aimed to investigate structural abnormalities within the mesocortical and limbic cortices and subcortical structures in PD patients with ICDs. We studied 18 PD patients with ICDs, 18 PD patients without ICDs and a group of 24 age and sex-matched healthy controls. Cortical thickness (CTh) and subcortical nuclei volume analyses were carried out using the automated surface-based analysis package FreeSurfer (version 5.3.0). We found significant differences in MRI measures between the three groups. There was volume loss in the nucleus accumbens of both PD patients with ICDs and without ICDs compared to the control group. In addition, PD patients with ICDs showed significant atrophy in caudate, hippocampus and amygdala compared to the group of healthy controls. PD patients with ICDs had significant increased cortical thickness in rostral anterior cingulate cortex and frontal pole compared to PD patients without ICDs. Cortical thickness in rostral anterior cingulate and frontal pole was increased in PD patients with ICDs compared to the control group, but the differences failed to reach corrected levels of statistical significance. PD patients with ICDs showed increased cortical thickness in medial prefrontal regions. We speculate that these findings reflect either a pre-existing neural trait vulnerability to impulsivity or the expression of a maladaptive synaptic plasticity under non-physiological dopaminergic stimulation.

  5. Gender differences in the relationship between impulsivity and disordered eating behaviors and attitudes.

    Science.gov (United States)

    Lundahl, Alyssa; Wahlstrom, Laura C; Christ, Christa C; Stoltenberg, Scott F

    2015-08-01

    We investigated relationships among gender, impulsivity and disordered eating in healthy college students. Participants (N=1223) were healthy, undergraduate men (28.5%) and women (71.5%), who completed the Barratt Impulsiveness Scale - Version 11 (BIS-11) and a four-factor version of the Eating Attitudes Test (EAT-16). As predicted, mean scores on all four EAT-16 factors were significantly higher for women than for men. Attentional impulsivity was related to poorer self-perception of body shape, more dieting, and a greater preoccupation with food for the sample as a whole. Moreover, motor impulsivity was related to poorer self-perceptions of body shape and a greater preoccupation with food. However, no gender differences emerged in the relationship between impulsivity and disordered eating attitudes. This study elucidates the role of impulsivity in disordered eating behaviors among non-clinical college students. For both women and men, attentional and motor impulsivity were related to disordered eating attitudes and behaviors. Overall, these findings suggest that different facets of impulsivity are related to disordered eating attitudes and behaviors in a non-clinical college population. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Individual differences in components of impulsivity and effortful control moderate the relation between borderline personality disorder traits and emotion recognition in a sample of university students.

    Science.gov (United States)

    Preti, Emanuele; Richetin, Juliette; Suttora, Chiara; Pisani, Alberto

    2016-04-30

    Dysfunctions in social cognition characterize personality disorders. However, mixed results emerged from literature on emotion processing. Borderline Personality Disorder (BPD) traits are either associated with enhanced emotion recognition, impairments, or equal functioning compared to controls. These apparent contradictions might result from the complexity of emotion recognition tasks used and from individual differences in impulsivity and effortful control. We conducted a study in a sample of undergraduate students (n=80), assessing BPD traits, using an emotion recognition task that requires the processing of only visual information or both visual and acoustic information. We also measured individual differences in impulsivity and effortful control. Results demonstrated the moderating role of some components of impulsivity and effortful control on the capability of BPD traits in predicting anger and happiness recognition. We organized the discussion around the interaction between different components of regulatory functioning and task complexity for a better understanding of emotion recognition in BPD samples. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. Impulsive behaviors in female patients with eating disorders in a university hospital in northern Taiwan

    Directory of Open Access Journals (Sweden)

    Kuei-Yu Liang

    2011-09-01

    Full Text Available Eating disorders (EDs are often associated with various impulsive behaviors. This study investigated the prevalence of impulsive behaviors in ED patients in Taiwan. Three hundred sixteen female outpatients with ED and 142 psychiatric controls were recruited. All participants completed self-administered questionnaires assessing lifetime presence of impulsive behaviors, including suicide, self-injury, stealing, alcohol use, illicit drug use, excessive spending, sexual promiscuity, and general psychopathology. More than 60% of the ED patients had at least one impulsive behavior. The most common impulsive behaviors among ED patients were excessive spending (34.9%, deliberate self-harm (32.7%, and stealing (26.3%. However, there were no significant differences in prevalences of any impulsive behaviors between ED patients and psychiatric controls. Clinicians should routinely assess and treat impulsive behaviors in female psychiatric patients with negative affectivity, regardless of the presence of ED, to help prevent potential adverse outcomes related to impulsive behaviors.

  8. Extrastriatal dopaminergic changes in Parkinson's disease patients with impulse control disorders.

    Science.gov (United States)

    Lee, Jee-Young; Seo, Seong Ho; Kim, Yu Kyeong; Yoo, Hye Bin; Kim, Young Eun; Song, In Chan; Lee, Jae Sung; Jeon, Beom S

    2014-01-01

    To investigate the extrastriatal dopaminergic neural changes in relation to the medication-related impulse control disorders (ICD) in Parkinson's disease (PD). A total of 31 subjects (11 and 11 drug-treated PD patients with and without medication-related ICDs and 9 healthy controls) having no other co-morbid psychiatric disorders participated in this study. Each subject underwent dynamic N-(3-[(18)F]fluoropropyl)-2-carbomethoxy-3-(4-iodophenyl) nortropane (FP-CIT) positron emission tomography scans. Binding potentials (BP) at nucleus accumbens, amygdala, orbitofrontal and ventromedial prefrontal cortex (VMPFC), putamen and caudate nucleus were estimated, and whole brain parametric maps of [(18)F]-FP-CIT binding were analysed by original and putaminal normalised manners. Compared with the healthy controls, BPs at both VMPFCs were significantly high and the extrastriatal to putaminal BP ratios at all regions were approximately three times higher in both PD groups. The PD ICD patients showed significantly higher BPs at the right VMPFC and tendency to lower BPs at the left nucleus accumbens compared with those free of ICD. The ICD subjects also showed reduced uptakes at both ventral striatal regions in the original parametric analysis and higher uptakes at the left insular and right posterior cingulate cortex and lower uptakes at both ventral pallidums in the putaminal normalised parametric analysis compared with the non-ICD subjects. A great gap in extrastriatal versus striatal dopaminergic fibre degenerations is an intrinsic condition predisposing to ICD in PD. Distinct pattern of extrastriatal changes between the ICD and non-ICD patients could provide a further insight into a mechanism of ICD in PD.

  9. Inattention and hyperactivity/impulsivity among children with attention-deficit/hyperactivity-disorder, autism spectrum disorder, and intellectual disability.

    Science.gov (United States)

    McClain, Maryellen Brunson; Hasty Mills, Amber M; Murphy, Laura E

    2017-11-01

    Attention-Deficit/Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), and Intellectual Disability (ID) are common co-occurring neurodevelopmental disorders; however, limited research exists regarding the presentation and severity of overlapping symptomology, particularly inattention and hyperactivity/impulsivity, when a child is diagnosed with one of more of these neurodevelopmental disorders. As difficulties with inattention and hyperactivity/impulsivity are symptoms frequently associated with these disorders, the current study aims to determine the differences in the severity of inattention and hyperactivity/impulsivity in children diagnosed with ADHD, ASD, ID, and co-occurring diagnosis of ADHD/ID, ASD/ADHD, and ASD/ID. Participants in the current study included 113 children between the ages of 6 and 11 who were diagnosed with ADHD, ASD, ID, ADHD/ID, ASD/ADHD, or ASD/ID. Two MANOVA analyses were used to compare these groups witih respsect to symptom (i.e., inattention, hyperactivity/impulsivity) severity. Results indicated that the majority of diagnostic groups experienced elevated levels of both inattention and hyperactivity/impulsivity. However, results yielded differences in inattention and hyperactivity/impulsivity severity. In addition, differences in measure sensitivity across behavioral instruments was found. Children with neurodevelopmental disorders often exhibit inattention and hyperactivity/impulsivity, particularly those with ADHD, ASD, ASD/ADHD, and ADHD/ID; therefore, differential diagnosis may be complicated due to similarities in ADHD symptom severity. However, intellectual abilities may be an important consideration for practitioners in the differential diagnosis process as children with ID and ASD/ID exhibited significantly less inattention and hyperactive/impulsive behaviors. Additionally, the use of multiple behavior rating measures in conjunction with other assessment procedures may help practitioners determine the most

  10. Specific cognitive-neurophysiological processes predict impulsivity in the childhood attention-deficit/hyperactivity disorder combined subtype.

    Science.gov (United States)

    Bluschke, A; Roessner, V; Beste, C

    2016-04-01

    Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent neuropsychiatric disorders in childhood. Besides inattention and hyperactivity, impulsivity is the third core symptom leading to diverse and serious problems. However, the neuronal mechanisms underlying impulsivity in ADHD are still not fully understood. This is all the more the case when patients with the ADHD combined subtype (ADHD-C) are considered who are characterized by both symptoms of inattention and hyperactivity/impulsivity. Combining high-density electroencephalography (EEG) recordings with source localization analyses, we examined what information processing stages are dysfunctional in ADHD-C (n = 20) compared with controls (n = 18). Patients with ADHD-C made more impulsive errors in a Go/No-go task than healthy controls. Neurophysiologically, different subprocesses from perceptual gating to attentional selection, resource allocation and response selection processes are altered in this patient group. Perceptual gating, stimulus-driven attention selection and resource allocation processes were more pronounced in ADHD-C, are related to activation differences in parieto-occipital networks and suggest attentional filtering deficits. However, only response selection processes, associated with medial prefrontal networks, predicted impulsive errors in ADHD-C. Although the clinical picture of ADHD-C is complex and a multitude of processing steps are altered, only a subset of processes seems to directly modulate impulsive behaviour. The present findings improve the understanding of mechanisms underlying impulsivity in patients with ADHD-C and might help to refine treatment algorithms focusing on impulsivity.

  11. Dopamine Gene Profiling to Predict Impulse Control and Effects of Dopamine Agonist Ropinirole.

    Science.gov (United States)

    MacDonald, Hayley J; Stinear, Cathy M; Ren, April; Coxon, James P; Kao, Justin; Macdonald, Lorraine; Snow, Barry; Cramer, Steven C; Byblow, Winston D

    2016-07-01

    Dopamine agonists can impair inhibitory control and cause impulse control disorders for those with Parkinson disease (PD), although mechanistically this is not well understood. In this study, we hypothesized that the extent of such drug effects on impulse control is related to specific dopamine gene polymorphisms. This double-blind, placebo-controlled study aimed to examine the effect of single doses of 0.5 and 1.0 mg of the dopamine agonist ropinirole on impulse control in healthy adults of typical age for PD onset. Impulse control was measured by stop signal RT on a response inhibition task and by an index of impulsive decision-making on the Balloon Analogue Risk Task. A dopamine genetic risk score quantified basal dopamine neurotransmission from the influence of five genes: catechol-O-methyltransferase, dopamine transporter, and those encoding receptors D1, D2, and D3. With placebo, impulse control was better for the high versus low genetic risk score groups. Ropinirole modulated impulse control in a manner dependent on genetic risk score. For the lower score group, both doses improved response inhibition (decreased stop signal RT) whereas the lower dose reduced impulsiveness in decision-making. Conversely, the higher score group showed a trend for worsened response inhibition on the lower dose whereas both doses increased impulsiveness in decision-making. The implications of the present findings are that genotyping can be used to predict impulse control and whether it will improve or worsen with the administration of dopamine agonists.

  12. Classifying eating disorders based on "healthy" and "unhealthy" perfectionism and impulsivity.

    Science.gov (United States)

    Slof-Op't Landt, Margarita C T; Claes, Laurence; van Furth, Eric F

    2016-07-01

    Perfectionism and impulsivity are associated with eating disorders (EDs). The current study examines whether clinically relevant subgroups of women with EDs can be identified based on "healthy" and "unhealthy" perfectionism and impulsivity. Latent profile analyses (LPA) were performed on data of 844 patients (DSM-IV diagnosis: 381 anorexia nervosa, 146 bulimia nervosa, 56 binge-eating disorder, 261 ED not otherwise specified). "Healthy" and "unhealthy" forms of perfectionism and impulsivity were assessed by the Frost Multidimensional Perfectionism Scale and the Dickman Impulsivity Inventory, respectively. The Eating Disorder Examination Questionnaire was completed to assess ED psychopathology. Furthermore, in 229 patients additional ED symptoms, depression, self-esteem, obsessive-compulsive symptoms, and personality features were assessed. The LPA revealed four profiles; 1. "Healthy Impulsivity" (HI; n = 191), 2. "Unhealthy Impulsivity" (UI; n = 238), 3. "Healthy and Unhealthy Perfectionism" (HP + UP; n = 153), 4. "Healthy Perfectionism" (HP; n = 262). Patients belonging to the "HP + UP" and the "UI" classes reported higher levels of ED psychopathology. More severe comorbid symptoms (depressive, obsessive-compulsive and self-esteem) were found in the patients belonging to the "HP + UP" class. Patients from the "HP + UP" and "HP" classes had higher scores for the personality features Harm Avoidance, Persistence and Cooperativeness. Women with EDs could be meaningfully grouped according to perfectionism and impulsivity. These findings can be used to improve treatment matching and intervention strategies. The use of dimensional features, like perfectionism and impulsivity, in ED research, may enable the identification of fundamental underlying mechanisms and provide more insight into potential mechanisms that may drive or maintain disordered eating. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:673-680). © 2016 Wiley

  13. Iowa Gambling Task Performance in Parkinson Disease Patients with Impulse Control Disorders.

    Science.gov (United States)

    Biars, Julia W; Johnson, Nicole L; Nespeca, Michelle; Busch, Robyn M; Kubu, Cynthia S; Floden, Darlene P

    2018-04-27

    A subgroup of patients with Parkinson disease (PD) develops impulse control disorders (ICD) associated with their dopamine replacement therapy. Patients and their families may be reluctant to report ICD symptoms or unaware these symptoms are related to PD medication, which can make detecting an ICD difficult for clinicians. Ideally, a behavioral measure that is sensitive to ICD could be employed to ensure that patients with these behaviors are identified and treated. The Iowa Gambling Task (IGT), a standardized decision-making task, has proven sensitive in other populations with impulse control problems. We hypothesized that the IGT would differentiate between PD patients with and without ICD. We compared IGT performance and disease variables in 24 PD patients with ICD and 24 PD patients without ICD. Patient groups were matched in terms of age, sex, and duration of PD. There were no significant differences in IGT scores between PD groups. IGT performance declined with increasing age, but the majority of patients performed within normal limits based on published age- and education-corrected normative data. The IGT did not distinguish between PD patients with and without ICD. Increasing age negatively impacted performance in both groups. Other studies have found that IGT performance may decline in normal aging. Our results suggest that the IGT lacks the sensitivity and specificity needed to differentiate between age-related deficits and disruption in frontal-subcortical circuits underlying ICD associated with PD medications. Therefore, the IGT is not an appropriate behavioral measure for ICD in PD patients.

  14. The Subthalamic Nucleus, Limbic Function, and Impulse Control.

    Science.gov (United States)

    Rossi, P Justin; Gunduz, Aysegul; Okun, Michael S

    2015-12-01

    It has been well documented that deep brain stimulation (DBS) of the subthalamic nucleus (STN) to address some of the disabling motor symptoms of Parkinson's disease (PD) can evoke unintended effects, especially on non-motor behavior. This observation has catalyzed more than a decade of research concentrated on establishing trends and identifying potential mechanisms for these non-motor effects. While many issues remain unresolved, the collective result of many research studies and clinical observations has been a general recognition of the role of the STN in mediating limbic function. In particular, the STN has been implicated in impulse control and the related construct of valence processing. A better understanding of STN involvement in these phenomena could have important implications for treating impulse control disorders (ICDs). ICDs affect up to 40% of PD patients on dopamine agonist therapy and approximately 15% of PD patients overall. ICDs have been reported to be associated with STN DBS. In this paper we will focus on impulse control and review pre-clinical, clinical, behavioral, imaging, and electrophysiological studies pertaining to the limbic function of the STN.

  15. Relationship between suicidality and impulsivity in bipolar I disorder: a diffusion tensor imaging study

    Science.gov (United States)

    Mahon, Katie; Burdick, Katherine E; Wu, Jinghui; Ardekani, Babak A; Szeszko, Philip R

    2012-01-01

    Background Impulsivity is characteristic of individuals with bipolar disorder and may be a contributing factor to the high rate of suicide in patients with this disorder. Although white matter abnormalities have been implicated in the pathophysiology of bipolar disorder, their relationship to impulsivity and suicidality in this disorder has not been well-investigated. Methods Diffusion tensor imaging scans were acquired in 14 bipolar disorder patients with a prior suicide attempt, 15 bipolar disorder patients with no prior suicide attempt, and 15 healthy volunteers. Bipolar disorder patients received clinical assessments including measures of impulsivity, depression, mania, and anxiety. Images were processed using the Tract-Based Spatial Statistics method in the FSL software package. Results Bipolar disorder patients with a prior suicide attempt had lower fractional anisotropy (FA) within the left orbital frontal white matter (p impulsivity compared to patients without a previous suicide attempt. Among patients with a prior suicide attempt, FA in the orbital frontal white matter region correlated inversely with motor impulsivity. Conclusions Abnormal orbital frontal white matter may play a role in impulsive and suicidal behavior among patients with bipolar disorder. PMID:22329475

  16. Incident impulse control disorder symptoms and dopamine transporter imaging in Parkinson disease.

    Science.gov (United States)

    Smith, Kara M; Xie, Sharon X; Weintraub, Daniel

    2016-08-01

    To describe the incidence of, and clinical and neurobiological risk factors for, new-onset impulse control disorder (ICD) symptoms and related behaviours in early Parkinson disease (PD). The Parkinson's Progression Markers Initiative is an international, multicenter, prospective study of de novo patients with PD untreated at baseline and assessed annually, including serial dopamine transporter imaging (DAT-SPECT) and ICD assessment (Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease short form, QUIP). Participants were included if they screened negative on the QUIP at baseline. Kaplan-Meier curves and generalised estimating equations examined frequency and predictors of incident ICD symptoms. Participants were seen at baseline (n=320), year 1 (n=284), year 2 (n=217) and year 3 (n=96). Estimated cumulative incident rates of ICD symptoms and related behaviours were 8% (year 1), 18% (year 2) and 25% (year 3) and increased each year in those on dopamine replacement therapy (DRT) and decreased in those not on DRT. In participants on DRT, risk factors for incident ICD symptoms were younger age (OR=0.97, p=0.05), a greater decrease in right caudate (OR=4.03, p=0.01) and mean striatal (OR=6.90, p=0.04) DAT availability over the first year, and lower right putamen (OR=0.06, p=0.01) and mean total striatal (OR=0.25, p=0.04) DAT availability at any post-baseline visit. The rate of incident ICD symptoms increases with time and initiation of DRT in early PD. In this preliminary study, a greater decrease or lower DAT binding over time increases risk of incident ICD symptoms, conferring additional risk to those taking DRT. NCT01141023. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  17. The Young and the Stressed: Stress, Impulse Control, and Health in College Students.

    Science.gov (United States)

    Leppink, Eric W; Odlaug, Brian L; Lust, Katherine; Christenson, Gary; Grant, Jon E

    2016-12-01

    High levels of stress are common among young adults, particularly those enrolled in college. These degrees of stress have shown numerous deleterious effects across both academic and health variables. Findings regarding the role of stress in the presentation of impulse control disorders, particular among college students, are limited. This study examined potential associations between perceived stress, academic achievement, physical/mental health, and impulse control disorders in young adults. A total of 1805 students completed an online survey and were included in the analysis. Responders were grouped by their overall score on the Perceived Stress Scale into mild, moderate, or severe. Severe perceived stress was associated with worse academic achievement and worse physical health, as well as higher rates of psychiatric and impulsive disorders. These findings may suggest associations between stress and numerous aspects of mental/physical health in young adults, which could be an important consideration for individuals working with college students.

  18. Proficient motor impulse control in Parkinson disease patients with impulsive and compulsive behaviors.

    Science.gov (United States)

    Claassen, Daniel O; van den Wildenberg, Wery P M; Harrison, Madaline B; van Wouwe, Nelleke C; Kanoff, Kristen; Neimat, Joseph S; Wylie, Scott A

    2015-02-01

    Parkinson disease (PD) patients treated with dopamine agonist therapy can develop maladaptive reward-driven behaviors, known as impulse control disorder (ICD). In this study, we assessed if ICD patients have evidence of motor-impulsivity. We used the stop-signal task in a cohort of patients with and without active symptoms of ICD to evaluate motor-impulsivity. Of those with PD, 12 were diagnosed with ICD symptoms (PD-ICD) and were assessed before clinical reduction of dopamine agonist medication; 12 were without symptoms of ICD [PD-control] and taking equivalent dosages of dopamine agonist. Levodopa, if present, was maintained in both settings. Groups were similar in age, duration, and severity of motor symptoms, levodopa co-therapy, and total levodopa daily dose. All were tested in the dopamine agonist medicated and acutely withdrawn (24 h) state, in a counterbalanced manner. Primary outcome measures were mean reaction time to correct go trials (go reaction time), and mean stop-signal reaction time (SSRT). ICD patients produce faster SSRT than both Healthy Controls, and PD-Controls. Faster SSRT in ICD patients is apparent in both dopamine agonist medication states. Also, we show unique dopamine medication effects on Go Reaction time (GoRT). In dopamine agonist monotherapy patients, dopamine agonist administration speeds GoRT. Conversely, in those with levodopa co-therapy, dopamine agonist administration slows. PD patients with active ICD symptoms are significantly faster at stopping initiated motor actions, and this is not altered by acute dopamine agonist withdrawal. In addition, the effect of dopamine agonist on GoRT is strongly influenced by the presence or absence of levodopa, even though levodopa co-therapy does not appear to influence SSRT. We discuss these findings as they pertain to the multifaceted definition of 'impulsivity,' the lack of evidence for motor-impulsivity in PD-ICD, and dopamine effects on motor-control in PD. Copyright © 2014 Elsevier Inc

  19. Altered structural correlates of impulsivity in adolescents with internet gaming disorder

    Directory of Open Access Journals (Sweden)

    Xin eDu

    2016-01-01

    Full Text Available Recent studies suggested that internet gaming disorder (IGD was associated with impulsivity and structural abnormalities in brain gray matter. However, no morphometric study has examined the association between gray matter and impulsivity in IGD individuals. In this study, 25 adolescents with IGD and 27 healthy controls (HCs were recruited, and the relationship between Barratt impulsiveness scale-11 (BIS score and gray matter volume (GMV was investigated with the voxel-based morphometric (VBM correlation analysis. Then, the intergroup differences in correlation between BIS score and GMV were tested across all gray matter voxels. Our results showed that the correlations between BIS score and GMV of the right dorsomedial prefrontal cortex, the bilateral insula and the orbitofrontal cortex, the right amygdala and the left fusiform gyrus decreased in the IGD group compared to the HCs. Region-of-interest (ROI analysis revealed that GMV in all these clusters showed significant positive correlations with BIS score in the HCs, while no significant correlation was found in the IGD group. Our findings demonstrated that dysfunction of these brain areas involved in the behavior inhibition, attention and emotion regulation might contribute to impulse control problems in IGD adolescents.

  20. Impulse control disorder related behaviours during long-term rotigotine treatment: a post hoc analysis.

    Science.gov (United States)

    Antonini, A; Chaudhuri, K R; Boroojerdi, B; Asgharnejad, M; Bauer, L; Grieger, F; Weintraub, D

    2016-10-01

    Dopamine agonists in Parkinson's disease (PD) are associated with impulse control disorders (ICDs) and other compulsive behaviours (together called ICD behaviours). The frequency of ICD behaviours reported as adverse events (AEs) in long-term studies of rotigotine transdermal patch in PD was evaluated. This was a post hoc analysis of six open-label extension studies up to 6 years in duration. Analyses included patients treated with rotigotine for at least 6 months and administered the modified Minnesota Impulse Disorders Interview. ICD behaviours reported as AEs were identified and categorized. For 786 patients, the mean (±SD) exposure to rotigotine was 49.4 ± 17.6 months. 71 (9.0%) patients reported 106 ICD AEs cumulatively. Occurrence was similar across categories: 2.5% patients reported 'compulsive sexual behaviour', 2.3% 'buying disorder', 2.0% 'compulsive gambling', 1.7% 'compulsive eating' and 1.7% 'punding behaviour'. Examining at 6-month intervals, the incidence was relatively low during the first 30 months; it was higher over the next 30 months, peaking in the 54-60-month period. No ICD AEs were serious, and 97% were mild or moderate in intensity. Study discontinuation occurred in seven (9.9%) patients with ICD AEs; these then resolved in five patients. Dose reduction occurred for 23 AEs, with the majority (73.9%) resolving. In this analysis of >750 patients with PD treated with rotigotine, the frequency of ICD behaviour AEs was 9.0%, with a specific incidence timeline observed. Active surveillance as duration of treatment increases may help early identification and management; once ICD behaviours are present rotigotine dose reduction may be considered. © 2016 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.

  1. Impulsivity in binge eating disorder: food cues elicit increased reward responses and disinhibition.

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    Kathrin Schag

    Full Text Available BACKGROUND: Binge eating disorder (BED represents a distinct eating disorder diagnosis. Current approaches assume increased impulsivity to be one factor leading to binge eating and weight gain. We used eye tracking to investigate both components of impulsivity, namely reward sensitivity and rash-spontaneous behaviour towards food in BED for the first time. METHODS: Overweight and obese people with BED (BED+; n = 25, without BED (BED-; n = 26 and healthy normal-weight controls (NWC; n = 25 performed a free exploration paradigm measuring reward sensitivity (experiment 1 and a modified antisaccade paradigm measuring disinhibited, rash-spontaneous behaviour (experiment 2 using food and nonfood stimuli. Additionally, trait impulsivity was assessed. RESULTS: In experiment 1, all participants located their initial fixations more often on food stimuli and BED+ participants gazed longer on food stimuli in comparison with BED- and NWC participants. In experiment 2, BED+ participants had more difficulties inhibiting saccades towards food and nonfood stimuli compared with both other groups in first saccades, and especially towards food stimuli in second saccades and concerning sequences of first and second saccades. BED- participants did not differ significantly from NWC participants in both experiments. Additionally, eye tracking performance was associated with self-reported reward responsiveness and self-control. CONCLUSIONS: According to these results, food-related reward sensitivity and rash-spontaneous behaviour, as the two components of impulsivity, are increased in BED in comparison with weight-matched and normal-weight controls. This indicates that BED represents a neurobehavioural phenotype of obesity that is characterised by increased impulsivity. Interventions for BED should target these special needs of affected patients.

  2. Impulse control disorder, lysosomal malfunction and ATP13A2 insufficiency in Parkinsonism.

    Science.gov (United States)

    Liu, Jun-Ping; Li, Jianfeng; Lu, Yanhua; Wang, Lihui; Chen, Gang

    2017-02-01

    Lysosomal transport of cargos in neurons is essential for neuronal proteostasis, transmission and functional motors and behaviours. Lysosomal malfunction including storage disorders is involved in the pathogenesis of Parkinson's disease (PD). Given the unclear molecular mechanisms of diverse defects in PD phenotypes, especially behavioural deficits, this mini review explores the cellular contexts of PD impulse control disorders and the molecular aspects of lysosomal cross-membrane transports. Focuses are paid to trace metal involvements in α-synuclein assembly in Lewy bodies, the functions and molecular interactions of ATP13A2 as ATPase transporters in lysosomal membranes for cross-membrane trafficking and lysosomal homeostasis, and our current understandings of the neural circuits in ICD. Erroneously polarized distributions of cargos such as metals and lipids on each side of lysosomal membranes triggered by gene mutations and deregulated expression of ATP13A2 may thus instigate sensing protein structural changes such as aggregations, organelle degeneration, and specific neuronal ageing and death in Parkinsonism. © 2016 John Wiley & Sons Australia, Ltd.

  3. Increased risk of impulse control symptoms in Parkinson's disease with REM sleep behaviour disorder.

    Science.gov (United States)

    Fantini, M L; Macedo, L; Zibetti, M; Sarchioto, M; Vidal, T; Pereira, B; Marques, A; Debilly, B; Derost, P; Ulla, M; Vitello, N; Cicolin, A; Lopiano, L; Durif, F

    2015-02-01

    To assess the frequency of symptoms of impulse control disorders (ICD, namely pathological gambling, compulsive sexual behaviour, compulsive eating and compulsive shopping) and related behaviours (hobbyism, punding, walkabout and dopamine dysregulation syndrome) in patients with Parkinson's disease (PD) with and without probable rapid eye movement, sleep behaviour disorder (pRBD). Two hundred and sixteen consecutive PD patients, attending two university-based movement disorders clinics, were screened for p-RBD using the RBD Single Question and the RBD Screening Questionnaire (RBDSQ). Current ICDs and related behaviours symptoms were assessed with the Questionnaire for Impulsive-Compulsive Disorders in PD (QUIP)-short form. PD-pRBD patients (n=106/216;49%) had a longer PD duration, a higher Hoehn & Yahr score, a greater levodopa-equivalent daily dose (LEDD), but no difference in dopamine agonist use, compared to PD-without pRBD. A higher proportion of one or more current ICDs and related behaviours symptoms was reported in PD-pRBD compared to PD-without RBD (53% vs28%; p=0.0002). In a multivariate regression analysis accounting for gender, age of onset, PD duration, PD severity, depression score and total and dopaminergic agonist-LEDD, RBD was associated to a relative risk of 1.84 for any ICD or related behaviours symptoms (p=0.01), and to a risk of 2.59 for any ICD symptoms only (p=0.001). Furthermore, PD-pRBD had a more than fourfold risk for symptoms of pathological gambling (relative risk (RR): 4.87; p=0.049) compared to PD-without pRBD. The present study indicates that RBD is associated with an increased risk of developing symptoms of ICDs in PD. Identifying RBD in PD may help clinicians to choose the best therapeutic strategy. AU1023 Institutional Ethics Committee. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  4. Monoamine Oxidase-A Genetic Variants and Childhood Abuse Predict Impulsiveness in Borderline Personality Disorder.

    Science.gov (United States)

    Kolla, Nathan J; Meyer, Jeffrey; Sanches, Marcos; Charbonneau, James

    2017-11-30

    Impulsivity is a core feature of borderline personality disorder (BPD) and antisocial personality disorder (ASPD) that likely arises from combined genetic and environmental influences. The interaction of the low activity variant of the monoamine oxidase-A (MAOA-L) gene and early childhood adversity has been shown to predict aggression in clinical and non-clinical populations. Although impulsivity is a risk factor for aggression in BPD and ASPD, little research has investigated potential gene-environment (G×E) influences impacting its expression in these conditions. Moreover, G×E interactions may differ by diagnosis. Full factorial analysis of variance was employed to investigate the influence of monoamine oxidase-A (MAO-A) genotype, childhood abuse, and diagnosis on Barratt Impulsiveness Scale-11 (BIS-11) scores in 61 individuals: 20 subjects with BPD, 18 subjects with ASPD, and 23 healthy controls. A group×genotype×abuse interaction was present (F(2,49)=4.4, p =0.018), such that the interaction of MAOA-L and childhood abuse predicted greater BIS-11 motor impulsiveness in BPD. Additionally, BPD subjects reported higher BIS-11 attentional impulsiveness versus ASPD participants (t(1,36)=2.3, p =0.025). These preliminary results suggest that MAOA-L may modulate the impact of childhood abuse on impulsivity in BPD. Results additionally indicate that impulsiveness may be expressed differently in BPD and ASPD.

  5. Harms associated with taking nalmefene for substance use and impulse control disorders: A systematic review and meta-analysis of randomised controlled trials.

    Directory of Open Access Journals (Sweden)

    Karina Glies Vincents Johansen

    Full Text Available Nalmefene is a newly approved drug for alcohol use disorder, but the risk of harms has not been evaluated from empirical trial evidence.To assess the harm of nalmefene administered to individuals diagnosed with substance use or impulse control disorders by performing a systematic review and meta-analysis of randomised controlled trials.A search was performed in Cochrane Central Register of Controlled Trials (CENTRAL, 2014, MEDLINE via PubMed (1950, EMBASE via Ovid (1974, and Clinicaltrials.gov through December 2014.This study included only randomised controlled trials with placebo or active controls that administered nalmefene to adult individuals for treating impulse control and/or substance use disorders. Both published and unpublished randomised controlled trials were eligible for inclusion.Internal validity was assessed using the Cochrane risk-of-bias tool. Published information from the trials was supplemented by contact between reviewers and industry sponsor. Data were combined using two meta-approaches in fixed effects models; Peto Odds Ratios and risk differences were reported with 95% confidence intervals (95%CIs.Number of patients with serious adverse events, including specific psychiatric serious adverse events and withdrawals due to adverse events.Of 20 potentially relevant studies, 15 randomised controlled trials met the inclusion criteria, and 8 of these provided data enabling the meta-analysis. Overall, serious adverse events did not occur more often in the nalmefene group than in the placebo group (Peto Odds Ratio = 0.97 [95% CI 0.64-1.44]; P = 0.86. Risk of psychiatric serious adverse events was slightly elevated, albeit not at a statistically significant level (Peto Odds Ratio = 1.32 [95% CI 0.62, 2.83]; P = 0.47. Withdrawals due to adverse events were significantly more likely to occur with nalmefene compared to placebo (Peto Odds Ratio = 3.22 [95% CI 2.46-4.22]; P<0.001.The three-fold increased risk of withdrawal from

  6. Impulsive control of time-delay systems using delayed impulse and its application to impulsive master-slave synchronization

    International Nuclear Information System (INIS)

    Sun Jitao; Han Qinglong; Jiang Xiefu

    2008-01-01

    This Letter is concerned with impulsive control of a class of nonlinear time-delay systems. Some uniform stability criteria for the closed-loop time-delay system under delayed impulsive control are derived by using piecewise Lyapunov functions. Then the criteria are applied to impulsive master-slave synchronization of some secure communication systems with transmission delays and sample delays under delayed impulsive control. Two numerical examples are given to illustrate the effectiveness of the derived results

  7. Four factors of impulsivity differentiate antisocial and borderline personality disorders.

    Science.gov (United States)

    DeShong, Hilary L; Kurtz, John E

    2013-04-01

    Impulsivity is a shared criterion for the diagnosis of antisocial and borderline personality disorders, and this link may account for the high comorbidity rates between the two disorders. The current study aimed to differentiate between borderline and antisocial personality disorders using the four factors of impulsivity identified by Whiteside and Lynam (2001). Five hundred thirty-six undergraduate participants completed the personality assessment inventory (PAI; Morey, 1991) to assess borderline and antisocial personality features and the NEO personality inventory, third edition (NEO-PI-3; McCrae & Costa, 2010) to assess the four factors of impulsivity. Results indicate that negative urgency and lack of perseverance were significantly and uniquely related to borderline features, while sensation seeking and lack of premeditation were significantly and uniquely related to antisocial features. The implications of these results for improved differential diagnosis are discussed.

  8. Impulsivity: A deficiency of inhibitory control?

    NARCIS (Netherlands)

    Lansbergen, M.M.

    2007-01-01

    Impulsivity has been defined as acting without thinking. Impulsivity can be quantified by impulsivity questionnaires, but also by behavioral paradigms which tax inhibitory control. Previous research has repeatedly demonstrated deficient inhibitory control in psychopathological samples characterized

  9. Suicide risk in depression and bipolar disorder: Do impulsiveness-aggressiveness and pharmacotherapy predict suicidal intent?

    Directory of Open Access Journals (Sweden)

    Maurizio Pompili

    2008-03-01

    Full Text Available Maurizio Pompili1,2, Marco Innamorati3, Michele Raja4, Ilaria Falcone2, Giuseppe Ducci5, Gloria Angeletti2, David Lester6, Paolo Girardi2, Roberto Tatarelli2, Eleonora De Pisa21McLean Hospital, Harvard Medical School, Boston, MA, USA; 2Department of Psychiatry, Sant’Andrea Hospital, “Sapienza” University of Rome, Italy; 3Università Europea di Roma, Italy; 4Diagnostic and Therapeutic Psychiatric Services, Department of Mental Health, Santo Spirito Hospital, Rome, Italy; 5Diagnostic and Therapeutic Psychiatric Services, Department of Mental Health, San Filippo Neri Hospital, Rome, Italy; 6Center for the Study of Suicide, Blackwood, NJ, USAAbstract: The aims of the present study were to examine clinical, personality, and sociodemographic predictors of suicide risk in a sample of inpatients affected by major affective disorders. The participants were 74 inpatients affected by major depressive disorder or bipolar disorder-I. Patients completed a semi-structured interview, the Beck Hopelessness Scale, the Aggression Questionnaire, the Barratt Impulsiveness Scale, and the Hamilton scales for depression and anxiety. Over 52% of the patients were high suicide risks. Those at risk reported more severe depressive-anxious symptomatology, more impulsivity and more hostility. Impulsivity, the use of antidepressants, anxiety/somatization, and the use of mood stabilizers (a negative predictor resulted in accurate predicting of suicide intent. Impulsivity and antidepressant use were the strongest predictors even after controlling for several sociodemographic and clinical variables.Keywords: suicide, mood disorders, pharmacotherapy, impulsiveness, aggressiveness

  10. Study of relation of cognitive emotion regulation styles with impulsivity and borderline personality disorder among university students

    Directory of Open Access Journals (Sweden)

    mozafar Ghaffari

    2014-01-01

    Full Text Available Background : Cognitive emotion regulation plays an immense role to control mental disorders. The aim of this research was to study the relationship between cognitive emotion regulation styles and impulsivity and students, borderline personality disorders.   Materials and Methods: Statistical samples of this study included 200 students of Pyam-e-Noor university. Cognitive Emotion Regulation Questionnaire (CERQ, Barrat Impulsivity Scale (BIS and Borderline Personality Scale (STB have been used for data collection. The data was analyzed using Pearson correlation coefficient and multiple regression analysis.   Results: Between variable of borderline personality disorder, and styles self-blame, rumination, catastrophizing and blaming others there was a positive correlation, but a negative relationship with acceptance, positive refocusing and positive reappraisal styles was observed (p>0.05. There was a positive relationship between variable of impulsivity with styles of self-blame, rumination, catastrophizing and blaming others, but had a negative relationship with acceptance, positive refocusing and positive reappraisal styles (p>0.05. The results of multi-variable correlation coefficient with Enter method indicated that cognitive emotion regulation styles play a role in explaining borderline personality disorder (R2= 0.646 and impulsivity (R2= 0.645.  Conclusion: Training the effective strategies of cognitive emotion regulation should be considered as a part of the intervention in the treatment of impulsivity and borderline personality disorder.

  11. Co-occurrence of alcohol use disorder and behavioral addictions: relevance of impulsivity and craving.

    Science.gov (United States)

    Di Nicola, Marco; Tedeschi, Daniela; De Risio, Luisa; Pettorruso, Mauro; Martinotti, Giovanni; Ruggeri, Filippo; Swierkosz-Lenart, Kevin; Guglielmo, Riccardo; Callea, Antonino; Ruggeri, Giuseppe; Pozzi, Gino; Di Giannantonio, Massimo; Janiri, Luigi

    2015-03-01

    The aims of the study were to evaluate the occurrence of behavioral addictions (BAs) in alcohol use disorder (AUD) subjects and to investigate the role of impulsivity, personality dimensions and craving. 95 AUD outpatients (DSM-5) and 140 homogeneous controls were assessed with diagnostic criteria and specific tests for gambling disorder, compulsive buying, sexual, internet and physical exercise addictions, as well as with the Barratt Impulsiveness Scale (BIS-11) and Temperamental and Character Inventory-Revised (TCI-R). The Obsessive Compulsive Drinking Scale (OCDS) and Visual Analogue Scale for craving (VASc) were also administered to the AUD sample. 28.4% (n=27) of AUD subjects had at least one BA, as compared to 15% (n=21) of controls (χ(2)=6.27; p=.014). In AUD subjects, direct correlations between BIS-11 and Compulsive Buying Scale (CBS), Internet Addiction Disorder test (IAD), Exercise Addiction Inventory-Short Form (EAI-SF) scores (paddictive behaviors. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. Neuronal codes for the inhibitory control of impulsive actions in the rat infralimbic cortex.

    Science.gov (United States)

    Tsutsui-Kimura, Iku; Ohmura, Yu; Izumi, Takeshi; Matsushima, Toshiya; Amita, Hidetoshi; Yamaguchi, Taku; Yoshida, Takayuki; Yoshioka, Mitsuhiro

    2016-01-01

    Poor impulse control is a debilitating condition observed in various psychiatric disorders and could be a risk factor for drug addiction, criminal involvement, and suicide. The rat infralimbic cortex (IL), located in the ventral portion of the medial prefrontal cortex, has been implicated in impulse control. To elucidate the neurophysiological basis of impulse control, we recorded single unit activity in the IL of a rat performing a 3-choiceserial reaction time task (3-CSRTT) and 2-choice task (2-CT), which are animal models for impulsivity. The inactivation of IL neuronal activity with an injection of muscimol (0.1 μg /side) disrupted impulse control in the 3-CSRTT. More than 60% (38/56) of isolated IL units were linked to impulse control, while approximately 30% of all units were linked to attentional function in the 3-CSRTT. To avoid confounding motor-related units with the impulse control-related units, we further conducted the 2-CT in which the animals' motor activities were restricted during recording window. More than 30% (14/44) of recorded IL units were linked to impulse control in the 2-CT. Several types of impulse control-related units were identified. Only 16% of all units were compatible with the results of the muscimol experiment, which showed a transient decline in the firing rate immediately before the release of behavioral inhibition. This is the first study to elucidate the neurophysiological basis of impulse control in the IL and to propose that IL neurons control impulsive actions in a more complex manner than previously considered. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. A Serious Videogame as an Additional Therapy Tool for Training Emotional Regulation and Impulsivity Control in Severe Gambling Disorder

    OpenAIRE

    T?rrega, Salom?; Castro-Carreras, Laia; Fern?ndez-Aranda, Fernando; Granero, Roser; Giner-Bartolom?, Cristina; Aymam?, Neus; G?mez-Pe?a, M?nica; Santamar?a, Juan J.; Forcano, Laura; Steward, Trevor; Mench?n, Jos? M.; Jim?nez-Murcia, Susana

    2015-01-01

    Background: Gambling disorder (GD) is characterized by a significant lack of self-control and is associated with impulsivity-related personality traits. It is also linked to deficits in emotional regulation and frequently co-occurs with anxiety and depression symptoms. There is also evidence that emotional dysregulation may play a mediatory role between GD and psychopathological symptomatology. Few studies have reported the outcomes of psychological interventions that specifically address the...

  14. Sociodemographic, neuropsychiatric and cognitive characteristics of pathological gambling and impulse control disorders NOS in Parkinson's disease.

    Science.gov (United States)

    Pontieri, Francesco E; Assogna, Francesca; Pellicano, Clelia; Cacciari, Claudia; Pannunzi, Sara; Morrone, Annalucia; Danese, Emanuela; Caltagirone, Carlo; Spalletta, Gianfranco

    2015-01-01

    Despite of previous evidence supporting the association between impulse control disorder (ICD) and several demographic, clinical and therapeutic features in Parkinson's disease (PD), the relationships between pathological gambling (PG) or other variants of ICD (ICD-NOS) and specific neuropsychiatric or cognitive domains are not entirely defined. In this study, 155 PD patients without dementia or cognitive impairment underwent: i. the ICD diagnoses, using the Questionnaire for Impulsive-Compulsive Disorders, ii. the mood and anxiety disorders diagnoses, according to the DSM-IV-TR criteria, and iii. a comprehensive battery for measuring severity of psychopathology and neuropsychology domains. Patients were divided in those with pathological gambling (PG), ICDs not otherwise specified (ICD-NOS), or the lack of ICD (No-ICD). There was a progression in age and age at onset from the younger PG subjects throughout ICD-NOS to No-ICD. PG and ICD-NOS subjects had longer disease duration and were taking significantly higher dosages of antiparkinsonian drugs than No-ICD ones. PG subjects had significantly higher severity of depressive and anxious symptoms with respect to the other 2 groups. Both PG and ICD-NOS subjects suffer from increased severity of psychotic symptoms than No-ICD ones. The 3 groups did not differ in any cognitive measure. Our results support the concept that the different sociodemographic and neuropsychiatric profiles of PD patients are associated with different ICDs. Moreover, we clearly demonstrate the lack of relationship between ICD and cognitive performances in undemented PD patients. Copyright © 2014 Elsevier B.V. and ECNP. All rights reserved.

  15. Impulse control disorder in PD: A lateralized monoaminergic frontostriatal disconnection syndrome?

    Science.gov (United States)

    Premi, E; Pilotto, A; Garibotto, V; Bigni, B; Turrone, R; Alberici, A; Cottini, E; Poli, L; Bianchi, M; Formenti, A; Cosseddu, M; Gazzina, S; Magoni, M; Bertoli, M; Paghera, B; Borroni, B; Padovani, A

    2016-09-01

    Impulse Control Disorder symptoms (ICD) in Parkinson's disease (PD) has been recently associated by magnetic Resonance imaging with impaired cortico-striatal connectivity, especially between left putamen and frontal associative areas. 84 patients entered the study (21 PD-ICD+ and 64 PD-ICD-) and underwent DATSCAN imaging. The striatal tracer uptake was evaluated using BRASS software (Hermes, Sweden). The whole-brain analysis was performed with Statistical Parametric Mapping (SPM). PD-ICD+ showed a significant reduction of left putaminal and left inferior frontal gyrus tracer uptake compared to PD-ICD-. Functional covariance analysis using left putamen as the seed point showed that, in contrast to ICD-patients, ICD+ patients had no functional covariance with contralateral basal ganglia and ipsilateral cingulate cortex, as index of an impaired inter- and intra-hemispheric dopamine binding in PD-ICD+. the results support and expand the concept of a functional disconnection syndrome linked to ICD symptoms in PD patients through an asymmetric molecular frontostriatal network breakdown with left basal ganglia as central hub. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Does impulsivity predict outcome in treatment for binge eating disorder? A multimodal investigation.

    Science.gov (United States)

    Manasse, Stephanie M; Espel, Hallie M; Schumacher, Leah M; Kerrigan, Stephanie G; Zhang, Fengqing; Forman, Evan M; Juarascio, Adrienne S

    2016-10-01

    Multiple dimensions of impulsivity (e.g., affect-driven impulsivity, impulsive inhibition - both general and food-specific, and impulsive decision-making) are associated with binge eating pathology cross-sectionally, yet the literature on whether impulsivity predicts treatment outcome is limited. The present pilot study explored impulsivity-related predictors of 20-week outcome in a small open trial (n = 17) of a novel treatment for binge eating disorder. Overall, dimensions of impulsivity related to emotions (i.e., negative urgency) and food cues emerged as predictors of treatment outcomes (i.e., binge eating frequency and global eating pathology as measured by the Eating Disorders Examination), while more general measures of impulsivity were statistically unrelated to global eating pathology or binge frequency. Specifically, those with higher levels of negative urgency at baseline experienced slower and less pronounced benefit from treatment, and those with higher food-specific impulsivity had more severe global eating pathology at baseline that was consistent at post-treatment and follow-up. These preliminary findings suggest that patients high in negative urgency and with poor response inhibition to food cues may benefit from augmentation of existing treatments to achieve optimal outcomes. Future research will benefit from replication with a larger sample, parsing out the role of different dimensions of impulsivity in treatment outcome for eating disorders, and identifying how treatment can be improved to accommodate higher levels of baseline impulsivity. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Lower Frequency of co-Morbid Medical Disorders Related to Poor Impulse Control in Parkinson's than Alzheimer's Disease.

    Science.gov (United States)

    Saito, Erin K; Diaz, Natalie; Morrow, Julia; Chung, Julia; McMurtray, Aaron

    2016-01-01

    Parkinson's disease is associated with progressive degeneration of mesolimbic dopaminergic neurons that are involved in reward-based behavior learning, including rewarding effects of food consumption and drugs of abuse. The importance of this pathway in development of addictive behaviors led us to hypothesize that medical disorders related to poor impulse control may occur less frequently among patients with Parkinson's disease than those with other progressive neurodegenerative disorders such as Alzheimer's disease. Retrospective cross-sectional study of all patients treated for Parkinson's disease and Alzheimer's disease in a community based clinic during a two-year period. Associations were summarized using odds ratios (OR) and 95% confidence intervals (95% CI) estimated from logistic regression models, adjusted for differences in gender distribution between the groups. A total of 106 patients with Parkinson's disease and 72 patients with Alzheimer's disease were included. Patients with Parkinson's disease were less likely to have either past substance use (adjusted OR = 0.035, 95% CI = 0.009 - 0.130) or presence of co-morbid medical conditions related to poor dietary choices (adjusted OR = 0.157, 95% CI = 0.062 - 0.397). Co-morbid medical conditions related to poor impulse control occur less frequently among those with Parkinson's disease than those with Alzheimer's disease. These findings are consistent with dysfunction of dopamine dependent pathways involved in addiction during the presymptomatic phase of Parkinson's disease and support a biological basis for addiction.

  18. Impulse Control and Callous-Unemotional Traits Distinguish Patterns of Delinquency and Substance Use in Justice Involved Adolescents: Examining the Moderating Role of Neighborhood Context.

    Science.gov (United States)

    Ray, James V; Thornton, Laura C; Frick, Paul J; Steinberg, Laurence; Cauffman, Elizabeth

    2016-04-01

    Both callous-unemotional (CU) traits and impulse control are known risk factors associated with delinquency and substance use. However, research is limited in how contextual factors such as neighborhood conditions influence the associations between these two dispositional factors and these two externalizing behaviors. The current study utilized latent class analysis (LCA) to identify unique classes of delinquency and substance use within an ethnically diverse sample (n = 1216) of justice-involved adolescents (ages 13 to 17) from three different sites. Neighborhood disorder, CU traits, and impulse control were all independently associated with membership in classes with more extensive histories of delinquency and substance use. The effects of CU traits and impulse control in distinguishing delinquent classes was invariant across levels of neighborhood disorder, whereas neighborhood disorder moderated the association between impulse control and substance use. Specifically, the probability of being in more severe substance using classes for those low in impulse control was stronger in neighborhoods with fewer indicators of social and physical disorder.

  19. A negative relationship between ventral striatal loss anticipation response and impulsivity in borderline personality disorder.

    Science.gov (United States)

    Herbort, Maike C; Soch, Joram; Wüstenberg, Torsten; Krauel, Kerstin; Pujara, Maia; Koenigs, Michael; Gallinat, Jürgen; Walter, Henrik; Roepke, Stefan; Schott, Björn H

    2016-01-01

    Patients with borderline personality disorder (BPD) frequently exhibit impulsive behavior, and self-reported impulsivity is typically higher in BPD patients when compared to healthy controls. Previous functional neuroimaging studies have suggested a link between impulsivity, the ventral striatal response to reward anticipation, and prediction errors. Here we investigated the striatal neural response to monetary gain and loss anticipation and their relationship with impulsivity in 21 female BPD patients and 23 age-matched female healthy controls using functional magnetic resonance imaging (fMRI). Participants performed a delayed monetary incentive task in which three categories of objects predicted a potential gain, loss, or neutral outcome. Impulsivity was assessed using the Barratt Impulsiveness Scale (BIS-11). Compared to healthy controls, BPD patients exhibited significantly reduced fMRI responses of the ventral striatum/nucleus accumbens (VS/NAcc) to both reward-predicting and loss-predicting cues. BIS-11 scores showed a significant positive correlation with the VS/NAcc reward anticipation responses in healthy controls, and this correlation, while also nominally positive, failed to reach significance in BPD patients. BPD patients, on the other hand, exhibited a significantly negative correlation between ventral striatal loss anticipation responses and BIS-11 scores, whereas this correlation was significantly positive in healthy controls. Our results suggest that patients with BPD show attenuated anticipation responses in the VS/NAcc and, furthermore, that higher impulsivity in BPD patients might be related to impaired prediction of aversive outcomes.

  20. Time perception, impulsivity, emotionality, and personality in self-harming borderline personality disorder patients.

    Science.gov (United States)

    Berlin, Heather A; Rolls, Edmund T

    2004-08-01

    To investigate how time perception may contribute to the symptoms of self-harming Borderline Personality Disorder (BPD) patients, 19 self-harming BPD inpatients and 39 normal controls were given measures of time perception, impulsivity, personality, emotion, and BPD characteristics. A test sensitive to orbitofrontal cortex (OFC) function ("Frontal" Behavior Questionnaire) was also administered, as the OFC has been associated with impulsivity and time perception. BPD patients produced less time than controls, and this correlated with impulsiveness and other characteristics commonly associated with BPD. BPD patients were also less conscientious, extraverted, and open to experience, as well as more impulsive (self-report and behaviorally), emotional, neurotic, and reported more BPD characteristics, compared to controls. The results suggest that some of these core characteristics of BPD may be on a continuum with the normal population and, impulsivity in particular, may be related to time perception deficits (i.e., a faster subjective sense of time). Finally, BPD patients scored higher on the Frontal Behavior Questionnaire, suggesting that some symptoms of the BPD syndrome may be related to problems associated with the OFC. A control spatial working memory task (SWM) revealed that SWM deficits could not explain any of the BPD patients' poor performance. While impulsivity was correlated with time perception across all participants, emotionality, introversion, and lack of openness to experience were not. This suggests that different symptoms of the borderline personality syndrome may be separable, and therefore, related to different cognitive deficits, and potentially to different brain systems. This may have important implications for treatment strategies for BPD.

  1. Multiple modes of impulsivity in Parkinson's disease.

    Directory of Open Access Journals (Sweden)

    Cristina Nombela

    Full Text Available Cognitive problems are a major factor determining quality of life of patients with Parkinson's disease. These include deficits in inhibitory control, ranging from subclinical alterations in decision-making to severe impulse control disorders. Based on preclinical studies, we proposed that Parkinson's disease does not cause a unified disorder of inhibitory control, but rather a set of impulsivity factors with distinct psychological profiles, anatomy and pharmacology. We assessed a broad set of measures of the cognitive, behavioural and temperamental/trait aspects of impulsivity. Sixty adults, including 30 idiopathic Parkinson's disease patients (Hoehn and Yahr stage I-III and 30 healthy controls, completed a neuropsychological battery, objective behavioural measures and self-report questionnaires. Univariate analyses of variance confirmed group differences in nine out of eleven metrics. We then used factor analysis (principal components method to identify the structure of impulsivity in Parkinson's disease. Four principal factors were identified, consistent with four different mechanisms of impulsivity, explaining 60% of variance. The factors were related to (1 tests of response conflict, interference and self assessment of impulsive behaviours on the Barrett Impulsivity Scale, (2 tests of motor inhibitory control, and the self-report behavioural approach system, (3 time estimation and delay aversion, and (4 reflection in hypothetical scenarios including temporal discounting. The different test profiles of these four factors were consistent with human and comparative studies of the pharmacology and functional anatomy of impulsivity. Relationships between each factor and clinical and demographic features were examined by regression against factor loadings. Levodopa dose equivalent was associated only with factors (2 and (3. The results confirm that impulsivity is common in Parkinson's disease, even in the absence of impulse control disorders, and

  2. Abnormal gray matter volume and impulsivity in young adults with Internet gaming disorder.

    Science.gov (United States)

    Lee, Deokjong; Namkoong, Kee; Lee, Junghan; Jung, Young-Chul

    2017-09-08

    Reduced executive control is one of the central components of model on the development and maintenance of Internet gaming disorder (IGD). Among the various executive control problems, high impulsivity has consistently been associated with IGD. We performed voxel-based morphometric analysis with diffeomorphic anatomical registration by using an exponentiated Lie algebra algorithm (DARTEL) to investigate the relationship of gray matter abnormalities to impulsivity in IGD. Thirty-one young male adults whose excessive Internet gaming began in early adolescence, and 30 age-matched male healthy controls were examined. IGD subjects showed smaller gray matter volume (GMV) in brain regions implicated in executive control, such as the anterior cingulate cortex and the supplementary motor area. The GMVs in the anterior cingulate cortex and the supplementary motor area were negatively correlated with self-reporting scales of impulsiveness. IGD subjects also exhibited smaller GMV in lateral prefrontal and parietal cortices comprising the left ventrolateral prefrontal cortex and the left inferior parietal lobule when compared with healthy controls. The GMVs in the left ventrolateral prefrontal cortex were negatively correlated with lifetime usage of Internet gaming. These findings suggest that gray matter abnormalities in areas related to executive control may contribute to high impulsivity of young adults with IGD. Furthermore, alterations in the prefrontal cortex were related with long-term excessive Internet gaming during adolescence. © 2017 Society for the Study of Addiction.

  3. Increased impulsivity associated with severity of suicide attempt history in patients with bipolar disorder.

    Science.gov (United States)

    Swann, Alan C; Dougherty, Donald M; Pazzaglia, Peggy J; Pham, Mary; Steinberg, Joel L; Moeller, F Gerard

    2005-09-01

    Impulsivity is a prominent and measurable characteristic of bipolar disorder that can contribute to risk for suicidal behavior. The purpose of this study was to investigate the relationship between impulsivity and severity of past suicidal behavior, a potential predictor of eventual suicide, in patients with bipolar disorder. In bipolar disorder subjects with either a definite history of attempted suicide or no such history, impulsivity was assessed with both a questionnaire (Barratt Impulsiveness Scale) and behavioral laboratory performance measures (immediate memory/delayed memory tasks). Diagnosis was determined with the Structured Clinical Interview for DSM-IV. Interviews of patients and review of records were used to determine the number of past suicide attempts and the medical severity of the most severe attempt. Subjects with a history of suicide attempts had more impulsive errors on the immediate memory task and had shorter response latencies, especially for impulsive responses. Impulsivity was highest in subjects with the most medically severe suicide attempts. Effects were not accounted for by presence of depression or mania at the time of testing. Barratt Impulsiveness Scale scores were numerically, but not significantly, higher in subjects with suicide attempts. A history of alcohol abuse was associated with greater probability of a suicide attempt. Multivariate analysis showed that ethanol abuse history and clinical state at the time of testing did not have a significant effect after impulsivity was taken into account. These results suggest that a history of severe suicidal behavior in patients with bipolar disorder is associated with impulsivity, manifested as a tendency toward rapid, unplanned responses.

  4. Impulsivity, self-control, and hypnotic suggestibility.

    Science.gov (United States)

    Ludwig, V U; Stelzel, C; Krutiak, H; Prunkl, C E; Steimke, R; Paschke, L M; Kathmann, N; Walter, H

    2013-06-01

    Hypnotic responding might be due to attenuated frontal lobe functioning after the hypnotic induction. Little is known about whether personality traits linked with frontal functioning are associated with responsiveness to hypnotic suggestions. We assessed whether hypnotic suggestibility is related to the traits of self-control and impulsivity in 154 participants who completed the Brief Self-Control Scale, the Self-Regulation Scale, the Barratt Impulsiveness Scale (BIS-11), and the Harvard Group Scale of Hypnotic Susceptibility (HGSHS:A). BIS-11 non-planning impulsivity correlated positively with HGSHS:A (Bonferroni-corrected). Furthermore, in the best model emerging from a stepwise multiple regression, both non-planning impulsivity and self-control positively predicted hypnotic suggestibility, and there was an interaction of BIS-11 motor impulsivity with gender. For men only, motor impulsivity tended to predict hypnotic suggestibility. Hypnotic suggestibility is associated with personality traits linked with frontal functioning, and hypnotic responding in men and women might differ. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. Assessing personal financial management in patients with bipolar disorder and its relation to impulsivity and response inhibition.

    Science.gov (United States)

    Cheema, Marvi K; MacQueen, Glenda M; Hassel, Stefanie

    2015-01-01

    Impulsivity and risk-taking behaviours are reported in bipolar disorder (BD). We examined whether financial management skills are related to impulsivity in patients with BD. We assessed financial management skills using the Executive Personal Finance Scale (EPFS), impulsivity using the Barratt Impulsiveness Scale (BIS) and response inhibition using an emotional go/no-go task in bipolar individuals (N = 21) and healthy controls (HC; N = 23). Patients had fewer financial management skills and higher levels of impulsivity than HC. In patients and controls, increased impulsivity was associated with poorer personal financial management. Patients and HC performed equally on the emotional go/no-go task. Higher BIS scores were associated with faster reaction times in HC. In patients, however, higher BIS scores were associated with slower reaction times, possibly indicating compensatory cognitive strategies to counter increased impulsivity. Patients with BD may have reduced abilities to manage personal finances, when compared against healthy participants. Difficulty with personal finance management may arise in part as a result of increased levels of impulsivity. Patients may learn to compensate for increased impulsivity by modulating response times in our experimental situations although whether such compensatory strategies generalize to real-world situations is unknown.

  6. Treatment of impulse control disorders in Parkinson's disease: Practical considerations and future directions.

    Science.gov (United States)

    Ramirez-Zamora, Adolfo; Gee, Lucy; Boyd, James; Biller, José

    2016-01-01

    Impulse control disorders (ICDs) including compulsive gambling, buying, sexual behaviors, and eating occur relatively frequently in Parkinson disease (PD) with at least one ICD identified in 14% of PD patients in a large, multicenter, observational study. ICDs behaviors range widely in severity but can lead to catastrophic consequences, including financial ruin, divorce, loss of employment, and increased health risks. The main risk factor for ICDs in PD is the use of Dopamine agonists (DAs) and discontinuation of the offending agent is considered first line treatment. However, many patients do not tolerate this intervention as consequence of increased motor and psychiatric disability or appearance of DA withdrawal syndrome. In this article, we review current management strategies and emerging new interventions for treatment of ICDs in PD. Pharmacological treatment should be individualized based on patient's unique neuropsychiatric profile, social support, medical comorbidities, tolerability and motor symptoms.

  7. Differentiating risk for mania and borderline personality disorder: The nature of goal regulation and impulsivity.

    Science.gov (United States)

    Fulford, Daniel; Eisner, Lori R; Johnson, Sheri L

    2015-06-30

    Researchers and clinicians have long noted the overlap among features and high comorbidity of bipolar disorder and borderline personality disorder. The shared features of impulsivity and labile mood in both disorders make them challenging to distinguish. We tested the hypothesis that variables related to goal dysregulation would be uniquely related to risk for mania, while emotion-relevant impulsivity would be related to risk for both disorders. We administered a broad range of measures related to goal regulation traits and impulsivity to 214 undergraduates. Findings confirmed that risk for mania, but not for borderline personality disorder, was related to higher sensitivity to reward and intense pursuit of goals. In contrast, borderline personality disorder symptoms related more strongly than did mania risk with threat sensitivity and with impulsivity in the context of negative affect. Results highlight potential differences and commonalities in mania risk versus borderline personality disorder risk. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. A serious videogame as an additional therapy tool for training emotional regulation and impulsivity control in severe gambling disorder.

    Directory of Open Access Journals (Sweden)

    Salome eTarrega

    2015-11-01

    Full Text Available Background: Gambling disorder (GD is characterized by a significant lack of self-control and is associated with impulsivity-related personality traits. It is also linked to deficits in emotional regulation and frequently co-occurs with anxiety and depression symptoms. There is also evidence that emotional dysregulation may play a mediatory role between GD and psychopathological symptomatology. Few studies have reported the outcomes of psychological interventions that specifically address these underlying processes. Objectives: To assess the utility of the Playmancer platform, a serious video game, as an additional therapy tool in a CBT intervention for GD, and to estimate pre-post changes in measures of impulsivity, anger expression and psychopathological symptomatology. Method: The sample comprised a single group of 16 male treatment-seeking individuals with severe GD diagnosis. Therapy intervention consisted of 16 group weekly CBT sessions and, concurrently, 10 additional weekly sessions of a serious video game. Pre-post treatment scores on South Oaks Gambling Screen (SOGS, Barratt Impulsiveness Scale (BIS-11, I7 Impulsiveness Questionnaire (I7, State-Trait Anger Expression Inventory 2 (STAXI-2, Symptom Checklist-Revised (SCL-90-R, State-Trait Anxiety Inventory (STAI-S-T, and Novelty Seeking from the Temperament and Character Inventory-Revised (TCI-R were compared. Results: After the intervention, significant changes were observed in several measures of impulsivity, anger expression and other psychopathological symptoms. Dropout and relapse rates during treatment were similar to those described in the literature for CBT. Conclusion: Complementing CBT interventions for GD with a specific therapy approach like a serious video game might be helpful in addressing certain underlying factors which are usually difficult to change, including impulsivity and anger expression.

  9. A Serious Videogame as an Additional Therapy Tool for Training Emotional Regulation and Impulsivity Control in Severe Gambling Disorder.

    Science.gov (United States)

    Tárrega, Salomé; Castro-Carreras, Laia; Fernández-Aranda, Fernando; Granero, Roser; Giner-Bartolomé, Cristina; Aymamí, Neus; Gómez-Peña, Mónica; Santamaría, Juan J; Forcano, Laura; Steward, Trevor; Menchón, José M; Jiménez-Murcia, Susana

    2015-01-01

    Gambling disorder (GD) is characterized by a significant lack of self-control and is associated with impulsivity-related personality traits. It is also linked to deficits in emotional regulation and frequently co-occurs with anxiety and depression symptoms. There is also evidence that emotional dysregulation may play a mediatory role between GD and psychopathological symptomatology. Few studies have reported the outcomes of psychological interventions that specifically address these underlying processes. To assess the utility of the Playmancer platform, a serious video game, as an additional therapy tool in a CBT intervention for GD, and to estimate pre-post changes in measures of impulsivity, anger expression and psychopathological symptomatology. The sample comprised a single group of 16 male treatment-seeking individuals with severe GD diagnosis. Therapy intervention consisted of 16 group weekly CBT sessions and, concurrently, 10 additional weekly sessions of a serious video game. Pre-post treatment scores on South Oaks Gambling Screen (SOGS), Barratt Impulsiveness Scale (BIS-11), I7 Impulsiveness Questionnaire (I7), State-Trait Anger Expression Inventory 2 (STAXI-2), Symptom Checklist-Revised (SCL-90-R), State-Trait Anxiety Inventory (STAI-S-T), and Novelty Seeking from the Temperament and Character Inventory-Revised (TCI-R) were compared. After the intervention, significant changes were observed in several measures of impulsivity, anger expression and other psychopathological symptoms. Dropout and relapse rates during treatment were similar to those described in the literature for CBT. Complementing CBT interventions for GD with a specific therapy approach like a serious video game might be helpful in addressing certain underlying factors which are usually difficult to change, including impulsivity and anger expression.

  10. A Serious Videogame as an Additional Therapy Tool for Training Emotional Regulation and Impulsivity Control in Severe Gambling Disorder

    Science.gov (United States)

    Tárrega, Salomé; Castro-Carreras, Laia; Fernández-Aranda, Fernando; Granero, Roser; Giner-Bartolomé, Cristina; Aymamí, Neus; Gómez-Peña, Mónica; Santamaría, Juan J.; Forcano, Laura; Steward, Trevor; Menchón, José M.; Jiménez-Murcia, Susana

    2015-01-01

    Background: Gambling disorder (GD) is characterized by a significant lack of self-control and is associated with impulsivity-related personality traits. It is also linked to deficits in emotional regulation and frequently co-occurs with anxiety and depression symptoms. There is also evidence that emotional dysregulation may play a mediatory role between GD and psychopathological symptomatology. Few studies have reported the outcomes of psychological interventions that specifically address these underlying processes. Objectives: To assess the utility of the Playmancer platform, a serious video game, as an additional therapy tool in a CBT intervention for GD, and to estimate pre-post changes in measures of impulsivity, anger expression and psychopathological symptomatology. Method: The sample comprised a single group of 16 male treatment-seeking individuals with severe GD diagnosis. Therapy intervention consisted of 16 group weekly CBT sessions and, concurrently, 10 additional weekly sessions of a serious video game. Pre-post treatment scores on South Oaks Gambling Screen (SOGS), Barratt Impulsiveness Scale (BIS-11), I7 Impulsiveness Questionnaire (I7), State-Trait Anger Expression Inventory 2 (STAXI-2), Symptom Checklist-Revised (SCL-90-R), State-Trait Anxiety Inventory (STAI-S-T), and Novelty Seeking from the Temperament and Character Inventory-Revised (TCI-R) were compared. Results: After the intervention, significant changes were observed in several measures of impulsivity, anger expression and other psychopathological symptoms. Dropout and relapse rates during treatment were similar to those described in the literature for CBT. Conclusion: Complementing CBT interventions for GD with a specific therapy approach like a serious video game might be helpful in addressing certain underlying factors which are usually difficult to change, including impulsivity and anger expression. PMID:26617550

  11. Impulsive action and impulsive choice across substance and behavioral addictions: cause or consequence?

    Science.gov (United States)

    Grant, Jon E; Chamberlain, Samuel R

    2014-11-01

    Substance use disorders are prevalent and debilitating. Certain behavioral syndromes ('behavioral addictions') characterized by repetitive habits, such as gambling disorder, stealing, shopping, and compulsive internet use, may share clinical, co-morbid, and neurobiological parallels with substance addictions. This review considers overlap between substance and behavioral addictions with a particular focus on impulsive action (inability to inhibit motor responses), and impulsive choice (preference for immediate smaller rewards to the detriment of long-term outcomes). We find that acute consumption of drugs with abuse potential is capable of modulating impulsive choice and action, although magnitude and direction of effect appear contingent on baseline function. Many lines of evidence, including findings from meta-analyses, show an association between chronic drug use and elevated impulsive choice and action. In some instances, elevated impulsive choice and action have been found to predate the development of substance use disorders, perhaps signifying their candidacy as objective vulnerability markers. Research in behavioral addictions is preliminary, and has mostly focused on impulsive action, finding this to be elevated versus controls, similar to that seen in chronic substance use disorders. Only a handful of imaging studies has explored the neural correlates of impulsive action and choice across these disorders. Key areas for future research are highlighted along with potential implications in terms of neurobiological models and treatment. In particular, future work should further explore whether the cognitive deficits identified are state or trait in nature: i.e. are evident before addiction perhaps signaling risk; or are a consequence of repetitive engagement in habitual behavior; and effects of novel agents known to modulate these cognitive abilities on various addictive disorders. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Impulsivity-related traits and their relation to DSM-5 section II and III personality disorders.

    Science.gov (United States)

    Few, Lauren R; Lynam, Donald R; Miller, Joshua D

    2015-07-01

    Difficulties with impulse control are considered a core feature of personality disorders (PDs) as assessed by the Diagnostic and Statistical Manual of Mental Disorders (5th edition [DSM-5]; American Psychiatric Association, 2013). Despite this, there has been relatively little examination of the manner in which DSM-5 PDs are characterized by multidimensional models of impulsivity that parse this broad umbrella construct into smaller, more unidimensional constructs. Using the UPPS model and measure of impulsivity (Whiteside & Lynam, 2001), the relations between 4 impulsivity-related traits and interview-rated scores on both DSM-5 Section II and III PDs and PD traits were examined in a community sample of individuals currently receiving psychological or psychiatric care (N = 106). As expected, the UPPS traits manifested correlations with the new Section III trait model that were generally consistent with the assertion that this new DSM-5 trait model reflects a pathological variant of the Five-Factor Model (FFM; e.g., UPPS traits associated with FFM conscientiousness were most strongly related to DSM-5 disinhibition traits). Overall, the UPPS traits accounted best for variance in DSM-5 Section II and III Cluster B PDs, consistent with these PDs being characterized, in part, by emotionally and cognitively based forms of impulsivity. (c) 2015 APA, all rights reserved).

  13. Generalized synchronization via impulsive control

    International Nuclear Information System (INIS)

    Zhang Rong; Xu Zhenyuan; Yang, Simon X.; He Xueming

    2008-01-01

    This paper demonstrates theoretically that two completely different systems can implement GS via impulsive control, moreover by using impulsive control, for a given manifold y = H(x) we construct a response system to achieve GS with drive system and the synchronization manifold is y = H(x). Our theoretical results are supported by numerical examples

  14. Impulse position control algorithms for nonlinear systems

    Energy Technology Data Exchange (ETDEWEB)

    Sesekin, A. N., E-mail: sesekin@list.ru [Ural Federal University, 19 S. Mira, Ekaterinburg, 620002 (Russian Federation); Institute of Mathematics and Mechanics, Ural Division of Russian Academy of Sciences, 16 S. Kovalevskaya, Ekaterinburg, 620990 (Russian Federation); Nepp, A. N., E-mail: anepp@urfu.ru [Ural Federal University, 19 S. Mira, Ekaterinburg, 620002 (Russian Federation)

    2015-11-30

    The article is devoted to the formalization and description of impulse-sliding regime in nonlinear dynamical systems that arise in the application of impulse position controls of a special kind. The concept of trajectory impulse-sliding regime formalized as some limiting network element Euler polygons generated by a discrete approximation of the impulse position control This paper differs from the previously published papers in that it uses a definition of solutions of systems with impulse controls, it based on the closure of the set of smooth solutions in the space of functions of bounded variation. The need for the study of such regimes is the fact that they often arise when parry disturbances acting on technical or economic control system.

  15. Impulse position control algorithms for nonlinear systems

    Science.gov (United States)

    Sesekin, A. N.; Nepp, A. N.

    2015-11-01

    The article is devoted to the formalization and description of impulse-sliding regime in nonlinear dynamical systems that arise in the application of impulse position controls of a special kind. The concept of trajectory impulse-sliding regime formalized as some limiting network element Euler polygons generated by a discrete approximation of the impulse position control This paper differs from the previously published papers in that it uses a definition of solutions of systems with impulse controls, it based on the closure of the set of smooth solutions in the space of functions of bounded variation. The need for the study of such regimes is the fact that they often arise when parry disturbances acting on technical or economic control system.

  16. Unique aspects of impulsive traits in substance use and overeating: specific contributions of common assessments of impulsivity.

    Science.gov (United States)

    Beaton, Derek; Abdi, Hervé; Filbey, Francesca M

    2014-11-01

    Abstract Background: Impulsivity is a complex trait often studied in substance abuse and overeating disorders, but the exact nature of impulsivity traits and their contribution to these disorders are still debated. Thus, understanding how to measure impulsivity is essential for comprehending addictive behaviors. Identify unique impulsivity traits specific to substance use and overeating. Impulsive Sensation Seeking (ImpSS) and Barratt's Impulsivity scales (BIS) Scales were analyzed with a non-parametric factor analytic technique (discriminant correspondence analysis) to identify group-specific traits on 297 individuals from five groups: Marijuana (n = 88), Nicotine (n = 82), Overeaters (n = 27), Marijuauna + Nicotine (n = 63), and CONTROLs (n = 37). A significant overall factor structure revealed three components of impulsivity that explained respectively 50.19% (pperm Overeating: lacks focus, but plans (short and long term). Our results reveal impulsivity traits specific to each group. This may provide better criteria to define spectrums and trajectories - instead of categories - of symptoms for substance use and eating disorders. Defining symptomatic spectrums could be an important step forward in diagnostic strategies.

  17. Dopaminergic and Opioid Pathways Associated with Impulse Control Disorders in Parkinson’s Disease

    Directory of Open Access Journals (Sweden)

    Aleksander H. Erga

    2018-02-01

    Full Text Available IntroductionImpulse control disorders (ICDs are frequent non-motor symptoms in Parkinson’s disease (PD, with potential negative effects on the quality of life and social functioning. ICDs are closely associated with dopaminergic therapy, and genetic polymorphisms in several neurotransmitter pathways may increase the risk of addictive behaviors in PD. However, clinical differentiation between patients at risk and patients without risk of ICDs is still troublesome. The aim of this study was to investigate if genetic polymorphisms across several neurotransmitter pathways were associated with ICD status in patients with PD.MethodsWhole-exome sequencing data were available for 119 eligible PD patients from the Norwegian ParkWest study. All participants underwent comprehensive neurological, neuropsychiatric, and neuropsychological assessments. ICDs were assessed using the self-report short form version of the Questionnaire for Impulsive-Compulsive Disorders in PD. Single-nucleotide polymorphisms (SNPs from 17 genes were subjected to regression with elastic net penalization to identify candidate variants associated with ICDs. The area under the curve of receiver-operating characteristic curves was used to evaluate the level of ICD prediction.ResultsAmong the 119 patients with PD included in the analysis, 29% met the criteria for ICD and 63% were using dopamine agonists (DAs. Eleven SNPs were associated with ICDs, and the four SNPs with the most robust performance significantly increased ICD predictability (AUC = 0.81, 95% CI 0.73–0.90 compared to clinical data alone (DA use and age; AUC = 0.65, 95% CI 0.59–0.78. The strongest predictive factors were rs5326 in DRD1, which was associated with increased odds of ICDs, and rs702764 in OPRK1, which was associated with decreased odds of ICDs.ConclusionUsing an advanced statistical approach, we identified SNPs in nine genes, including a novel polymorphism in DRD1, with potential application for

  18. Prospective cohort study of impulse control disorders in Parkinson's disease.

    Science.gov (United States)

    Bastiaens, Jesse; Dorfman, Benjamin J; Christos, Paul J; Nirenberg, Melissa J

    2013-03-01

    Impulse control disorders (ICDs) are potentially serious side effects of dopamine agonist therapy in Parkinson's disease (PD), but prospective data are lacking about their incidence, time course, and risk factors. This work was a 4-year, prospective cohort study of outpatients with PD and no previous ICDs (N = 164). All subjects treated with a dopamine agonist during the study were followed longitudinally for new-onset ICDs. Baseline characteristics were compared in groups with (ICD+) and without (ICD-) subsequent ICDs. Forty-six subjects were treated with a dopamine agonist, including 25 who were newly treated and 21 who received ongoing dopamine agonist therapy. Of these 46 subjects, 18 (39.1%) developed new-onset ICDs. The timing of ICD onset varied from 3.0 to 114.0 months (median, 23.0) after initiation of dopamine agonist therapy. Baseline demographic characteristics were similar in ICD+ and ICD- groups. At baseline, ICD+ subjects had a greater prevalence of motor complications (61.1% versus 25.0%; P = 0.01) than ICD- subjects, despite comparable total dopaminergic medication usage in both groups (median, 150.0 versus 150.0 levodopa equivalents; P = 0.61). Compared with ICD- subjects, ICD+ subjects had a greater baseline prevalence of caffeine use (100% versus 66.7%; P = 0.007) and higher lifetime prevalence of cigarette smoking (44.4% versus 14.3%; P = 0.04). Peak dopamine agonist doses were higher in ICD+ than ICD- subjects (median 300.0 versus 165.0 L-dopa equivalents; P = 0.03), but cumulative dopamine agonist exposure was similar in both groups. In summary, the timing of new-onset ICDs in PD is highly variable. Risk factors include cigarette smoking, caffeine use, motor complications, and higher peak dopamine agonist dosage. Copyright © 2013 Movement Disorders Society.

  19. The role of self-awareness and cognitive dysfunction in Parkinson's disease with and without impulse-control disorder.

    Science.gov (United States)

    Mack, Joel; Okai, David; Brown, Richard G; Askey-Jones, Sally; Chaudhuri, K Ray; Martin, Anne; Samuel, Michael; David, Anthony S

    2013-01-01

    The aim of this study was to investigate the clinical, neuropsychological, and self-awareness correlates of impulse-control disorder (ICD) in a group of 17 Parkinson's disease (PD) subjects with an active ICD and a comparison group of 17 PD subjects without ICD. Self-awareness was assessed with the Beck Cognitive Insight Scale and patient-caregiver discrepancy scores from ratings on the Dysexecutive Questionnaire and the Everyday Memory Questionnaire-Revised. Self-awareness was comparable or increased in those with ICD, versus those without, and measures of neuropsychological functioning did not differ between the two groups. Those with ICD had more motor complications of PD therapy and were more likely to be on an antidepressant than those without ICD, whereas dopaminergic medication profiles were comparable between the two groups. In this group, PD patients with current ICDs were aware of their impulsivity. Although executive dysfunction may contribute to ICD behavior, it is not a necessary component. The awareness of the inability to resist these motivated behaviors may be a source of increased depression.

  20. Whole-brain diffusion-tensor changes in parkinsonian patients with impulse control disorders.

    Science.gov (United States)

    Yoo, Hye Bin; Lee, Jee-Young; Lee, Jae Sung; Kang, Hyejin; Kim, Yu Kyeong; Song, In Chan; Lee, Dong Soo; Jeon, Beom Seok

    2015-01-01

    The aim of this study was to determine the changes in diffusion-tensor images associated with medication-related impulse control disorder (ICD) in Parkinson's disease (PD) patients undergoing chronic dopamine-replacement therapy. Nineteen PD patients, comprising 10 with ICD (PD-ICD) and 9 without ICD (PD-nonICD), and 18 age-matched healthy controls (HCs) with no cognitive or other psychiatric disorders were analyzed. All subjects underwent 3-T magnetic resonance diffusion-tensor imaging. For all PD patients, clinical data on PD duration, antiparkinsonian medication dosages, Unified Parkinson's Disease Rating Scale and Mini-Mental State Examination were collected. Whole-brain voxel-based measures of fractional anisotropy (FA) and mean diffusivity (MD) were analyzed. In comparison with HCs, the PD-nonICD subjects had low FA at the bilateral orbitofrontal areas. While the PD-ICD subjects exhibited no such difference, their FA was significantly elevated at the anterior corpus callosum. Analysis of FA between the two PD groups revealed that FA in the anterior corpus callosum, right internal capsule posterior limbs, right posterior cingulum, and right thalamic radiations were significantly higher (corrected p<0.05) in the PD-ICD than in the PD-nonICD patients. MD did not differ between the PD-ICD and PD-nonICD groups in any brain regions. The PD-ICD patients appear to have relatively preserved white-matter integrity in the regions involved in reward-related behaviors compared to PD-nonICD patients. Further investigation is required to determine whether the difference in FA between PD-ICD and PD-nonICD patients reflects microstructural differences in the pathological progression of PD or is secondary to ICD.

  1. A European multicentre survey of impulse control behaviours in Parkinson's disease patients treated with short- and long-acting dopamine agonists

    DEFF Research Database (Denmark)

    Rizos, A; Sauerbier, A; Antonini, A

    2016-01-01

    BACKGROUND AND PURPOSE: Impulse control disorders (ICDs) in Parkinson's disease (PD) are associated primarily with dopamine agonist (DA) use. Comparative surveys of clinical occurrence of impulse control behaviours on longer acting/transdermal DA therapy across age ranges are lacking. The aim...... release PPX (PPX-IR) (19.0%; P controlling...

  2. Parkinson's Impulse-Control Scale for the Severity Rating of Impulse-Control Behaviors in Parkinson's Disease: A Semistructured Clinical Assessment Tool.

    Science.gov (United States)

    Okai, David; Askey-Jones, Sally; Mack, Joel; Martin, Anne; Chaudhuri, Kallol Ray; Samuel, Michael; David, Anthony S; Brown, Richard G

    2016-01-01

    Impulse-control behaviors (ICBs) are increasingly recognized in Parkinson's disease (PD) as drug-related effects of dopaminergic mediation that occur in 15% to 35% of patients with PD. The authors describe the design and evaluation of a new, clinician-rated severity scale for the assessment of syndromal and subsyndromal forms of impulse-control disorders (ICDs), simple (punding) and complex (hobbyism) repetitive behaviors, and compulsive overuse of medication (dopamine dysregulation syndrome). The Parkinson's Impulse-Control Scale (PICS), the first PD-specific, semistructured interview to cover the full range of PD-related ICBs, is described along with initial evidence on its clinimetric properties including interrater reliability, discriminant validity and sensitivity to change. A convenience sample of PD patients with ICBs and those without were administered a semistructured interview (n = 92). The scale distinguished between those with and without clinically detected ICBs and between patients with syndromal ICD and subsyndromal ICB (receiver operating characteristic areas under the curve, 92%-95%). Cutoff values were suggested, and substantial agreement was reported on weighted kappa (Κ) values for clinician-clinician rating of severity (Κ = 0.92). Significant improvements were detected on the scale after a randomized controlled trial of cognitive-behavioral therapy and medication adjustment ( t [22] = 5.47; P < 0.001). The PICS appears to be a reliable measure of the full range of PD ICBs with good levels of interrater reliability. It may provide a useful measure to assess the severity of ICBs and monitor change in clinical and research settings; although, given the specialized centers used for recruitment of this sample, further psychometric evaluation is required.

  3. The Relationship between Non-Suicidal Self-Injury and the UPPS-P Impulsivity Facets in Eating Disorders and Healthy Controls.

    Directory of Open Access Journals (Sweden)

    Laurence Claes

    Full Text Available In the present study, we investigated the association between Non-Suicidal Self-Injury (NSSI and the UPPS-P impulsivity facets in eating disorder patients and healthy controls. The prevalence of NSSI in eating disorder (ED patients ranged from 17% in restrictive anorexia nervosa (AN-R patients to 43% in patients with bulimia nervosa (BN. In healthy controls (HC, the prevalence of NSSI was 19%. Eating disorder patients from the binge eating/purging type showed significantly more NSSI compared to restrictive ED and HC participants. Binge-eating/purging ED patients also scored significantly higher on Negative/Positive Urgency, Lack of Premeditation and Lack of Perseverance compared to HC and restrictive ED patients. Comparable findings were found between ED patients and HC with and without NSSI; ED patients and HC with NSSI scored significantly higher in four of the five UPPS-P dimensions compared to participants without NSSI; Sensation Seeking was the exception. Finally, the presence of NSSI in HC/ED patients was particularly predicted by low levels of Perseverance. Therefore, the treatment of ED patients with NSSI certainly needs to focus on the training of effortful control.

  4. Risky decision-making and affective features of impulse control disorders in Parkinson's disease.

    Science.gov (United States)

    Martini, Alice; Ellis, Simon J; Grange, James A; Tamburin, Stefano; Dal Lago, Denise; Vianello, Greta; Edelstyn, Nicola M J

    2018-02-01

    Impulse control disorders (ICDs) in Parkinson's disease (PD) are considered dopaminergic treatment side effects. Cognitive and affective factors may increase the risk of ICD in PD. The aim is to investigate risky decision-making and associated cognitive processes in PD patients with ICDs within a four-stage conceptual framework. Relationship between ICDs and affective factors was explored. Thirteen PD patients with ICD (ICD+), 12 PD patients without ICD (ICD-), and 17 healthy controls were recruited. Overall risky decision-making and negative feedback effect were examined with the Balloon Analogue Risk Task (BART). A cognitive battery dissected decision-making processes according to the four-stage conceptual framework. Affective and motivational factors were measured. ANOVA showed no effect of group on overall risky decision-making. However, there was a group × feedback interaction [F (2, 39) = 3.31, p = 0.047]. ICD+, unlike ICD- and healthy controls, failed to reduce risky behaviour following negative feedback. A main effect of group was found for anxiety and depression [F(2, 38) = 8.31, p = 0.001], with higher symptoms in ICD+ vs. healthy controls. Groups did not differ in cognitive outcomes or affective and motivational metrics. ICD+ may show relatively preserved cognitive function, but reduced sensitivity to negative feedback during risky decision-making and higher symptoms of depression and anxiety.

  5. Aggressive behavior among military veterans in substance use disorder treatment: the roles of posttraumatic stress and impulsivity.

    Science.gov (United States)

    Heinz, Adrienne J; Makin-Byrd, Kerry; Blonigen, Daniel M; Reilly, Patrick; Timko, Christine

    2015-03-01

    This study examined posttraumatic stress disorder (PTSD) symptom severity and impulsivity as predictors of aggressive behavior among 133 male military veterans entering substance abuse treatment who endorsed difficulty controlling anger in the past year. At treatment intake, participants completed measures assessing PTSD symptom severity, impulsivity and aggressive behavior. Perpetration of aggressive behavior was reassessed 4 months later. Results from multivariate models indicated that PTSD symptom severity and impulsivity explained unique variance in aggressive behavior at intake but not follow-up. Mediation models indicated that the association between PTSD symptom severity and aggressive behavior was accounted for by impulsivity. The identification of impulsivity as a key mediator between trauma symptoms and aggressive behavior has significant clinical and research implications. Based on these findings, clinicians are encouraged to consider a standard assessment of impulsivity and the selection of interventions that target impulsivity as a trans-diagnostic process among at-risk client populations. Published by Elsevier Inc.

  6. Cognitive control training for emotion-related impulsivity.

    Science.gov (United States)

    Peckham, Andrew D; Johnson, Sheri L

    2018-06-01

    Many forms of psychopathology are tied to a heightened tendency to respond impulsively to strong emotions, and this tendency, in turn, is closely tied to problems with cognitive control. The goal of the present study was to test whether a two-week, six-session cognitive control training program is efficacious in reducing emotion-related impulsivity. Participants (N = 52) reporting elevated scores on an emotion-related impulsivity measure completed cognitive control training targeting working memory and response inhibition. A subset of participants were randomized to a waitlist control group. Impulsivity, emotion regulation, and performance on near and far-transfer cognitive tasks were assessed at baseline and after completion of training. Emotion-related impulsivity declined significantly from pre-training to post-training and at two-week follow-up; improvements were not observed in the waitlist control group. A decrease in brooding rumination and an increase in reappraisal were also observed. Participants showed significant improvements on trained versions of the working memory and inhibition tasks as well as improvements on an inhibition transfer task. In sum, these preliminary findings show that cognitive training appears to be well-tolerated for people with significant emotion-driven impulsivity. Results provide preliminary support for the efficacy of cognitive training interventions as a way to reduce emotion-related impulsivity. Copyright © 2018 Elsevier Ltd. All rights reserved.

  7. Trait impulsivity in suicide attempters: preliminary study.

    Science.gov (United States)

    Doihara, Chiho; Kawanishi, Chiaki; Ohyama, Nene; Yamada, Tomoki; Nakagawa, Makiko; Iwamoto, Yohko; Odawara, Toshinari; Hirayasu, Yoshio

    2012-10-01

    Suicide attempt is a risk factor for suicide. To investigate trait impulsivity among suicide attempters, 93 attempters admitted to an emergency department and 113 healthy controls were evaluated using the Japanese version of the Barratt Impulsiveness Scale (BIS-11J). Impulsivity was analyzed in relation to clinical data in the attempters. Total BIS-11J, attention impulsiveness, and motor impulsiveness scores were significantly higher in the attempters than in the controls. Both total BIS-11J and non-planning impulsiveness scores were significantly higher in attempters with schizophrenia and other psychotic disorders among the diagnostic groups. Control of impulsivity should be considered as one of the targets for suicide prevention. © 2012 The Authors. Psychiatry and Clinical Neurosciences © 2012 Japanese Society of Psychiatry and Neurology.

  8. Impulsive traits and 5-HT2A receptor promoter polymorphism in alcohol dependents: possible association but no influence of personality disorders.

    Science.gov (United States)

    Preuss, U W; Koller, G; Bondy, B; Bahlmann, M; Soyka, M

    2001-01-01

    polymorphism and impulsive behavior in alcohol dependents. This finding may refer only to impulsive traits and may be independent of personality disorders in this sample. These results have to be confirmed in larger samples and in healthy control subjects to determine whether this association is of general validity. Copyright 2001 S. Karger AG, Basel

  9. Impulse control disorder in patients with Parkinson's disease under dopamine agonist therapy: a multicentre study.

    Science.gov (United States)

    Garcia-Ruiz, Pedro J; Martinez Castrillo, Juan Carlos; Alonso-Canovas, Araceli; Herranz Barcenas, Antonio; Vela, Lydia; Sanchez Alonso, Pilar; Mata, Marina; Olmedilla Gonzalez, Nuria; Mahillo Fernandez, Ignacio

    2014-08-01

    Impulse control disorders (ICDs) encompass a wide spectrum of abnormal behaviour frequently found in cases of Parkinson's disease (PD) treated with dopamine agonists (DAs). The main aim of this study was to analyse ICD prevalence with different DAs. We carried out a multicentre transversal study to evaluate the presence of ICDs in patients with PD chronically treated (>6 months) with a single non-ergolinic DA (pramipexole, ropinirole, or rotigotine). Clinical assessment of ICD was performed using the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's disease. Thirty-nine per cent of patients (91/233) fulfilled the clinical criteria for ICD. The group of patients with ICD symptoms (ICD+) differed from those without ICD symptoms (ICD-) in younger age and type of DA intake. Oral DA treatment (pramipexole and ropinirole) was associated with higher risk of ICDs compared with transdermal DA (rotigotine): 84/197 (42%) patients treated with oral DA developed ICD, versus 7/36 (19%) patients treated with transdermal DA (Fisher's exact text <0.01). In univariate analysis, a younger age (p<0.01), treatment with rasagiline (p<0.05), and especially treatment with an oral DA (pramipexole or ropinirole) (p<0.01) were significantly associated with ICD. Multivariate analysis confirmed that oral DA remained significantly associated with ICD (p: 0.014, OR: 3.14; 1.26-7.83). ICD was significantly associated with the use of the non-ergolinic oral DA (pramipexole and ropinirole) when compared with transdermal non-ergolinic DA (rotigotine). Since pramipexole, ropinirole and rotigotine are non-ergolinic DAs with very similar pharmacodynamic profiles, it is likely that other factors including route of administration (transdermal vs oral) explain the difference in risk of ICD development. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  10. Impulsivity in adult ADHD patients with and without cocaine dependence

    NARCIS (Netherlands)

    Crunelle, C.L.; Veltman, D.J.; van Emmerik-van Oortmerssen, K.; Booij, J.; van den Brink, W.

    2013-01-01

    Background: Attention deficit hyperactivity disorder (ADHD) is present in about a quarter of patients with a substance use disorder (SUD) and impulsivity is a key feature of both disorders. However, very little is known about differences in impulse control and other cognitive functions between ADHD

  11. Overlapping and disease specific trait, response, and reflection impulsivity in adolescents with first-episode schizophrenia spectrum disorders or attention-deficit/hyperactivity disorder

    NARCIS (Netherlands)

    Jepsen, Jens Richardt M.; Rydkjaer, J.; Fagerlund, B.; Pagsberg, A. K.; Jespersen, R. Av F.; Glenthøj, Birte Y.; Oranje, B.

    BACKGROUND: Schizophrenia and attention-deficit/hyperactivity disorder (ADHD) are developmental disorders with shared clinical characteristics such as cognitive impairments and impulsivity. Impulsivity is a core feature of ADHD and an important factor in aggression, violence, and substance use in

  12. Impulsive lifestyle counseling to prevent dropout from treatment for substance use disorders in people with antisocial personality disorder: A randomized study.

    Science.gov (United States)

    Thylstrup, Birgitte; Hesse, Morten

    2016-06-01

    Patients with antisocial personality disorder in outpatient treatment for substance use disorders are at high risk of drop-out. Using a randomized design, this study tested the impact of adding a brief psycho-educational program, the Impulsive Lifestyle Counseling program, to outpatient substance abuse treatment in order to prevent treatment dropout. Patients (N=175) were recruited from 13 municipal treatment centers in Denmark, and assigned to treatment as usual or to the experimental condition. In all, 172 patients could be included in the analyses. In the intent-to-treat analysis, the risk of treatment dropout was reduced among patients randomized to the experimental program (hazard ratio=0.63, p=.031), after controlling for age, gender, and substitution treatment status. The study supported the efficacy of the Impulsive Lifestyle Counseling program as a method for preventing treatment dropout for patients with comorbid antisocial personality disorder in substance abuse treatment. Trial registration #ISRCTN67266318. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Maladaptive Reward-Learning and Impulse Control Disorders in Patients with Parkinson’s Disease: A Clinical Overview and Pathophysiology Update

    Directory of Open Access Journals (Sweden)

    Jee-Young Lee

    2014-10-01

    Full Text Available Impulse control disorders (ICD in Parkinson’s disease (PD are a disabling non-motor symptom with frequencies of 13–35% among patients receiving dopamine replacement therapy. ICD in PD is strongly associated with dopaminergic drug use, especially non-ergot dopamine agonists (DA. However, individual susceptibility and disease-related neural changes are also important contributors to the development of ICD. Discrepancies between nigrostriatal and mesolimbic dopaminergic degeneration and non-physiological administration of dopaminergic drugs may induce abnormal ’hyperstimulation’ of the mesolimbic system, which alters reward-learning behaviors in PD patients. In addition, DA can make patients more impulsive during decision-making and seek risk-taking behaviors. DA intake is also related to the biased representation of rewards. Ultimately, loss of negative feedback control due to dysfunctional frontostriatal connections is necessary for the establishment of ICD in PD. The subsequent behavioral and neural changes are affected by PD treatment and disease progression; thus, proper treatment guidelines for physicians are needed to prevent the development of ICD. Future studies aimed at producing novel therapeutics to control the risk factors for ICD or treat ICD behaviors in PD are warranted. This review summarizes recent advances from epidemiological and pathophysiological studies on ICD in PD. Management principles and limitations of current therapeutics are briefly discussed.

  14. Validation of the questionnaire for impulsive-compulsive disorders in Parkinson's disease.

    Science.gov (United States)

    Weintraub, Daniel; Hoops, Staci; Shea, Judy A; Lyons, Kelly E; Pahwa, Rajesh; Driver-Dunckley, Erika D; Adler, Charles H; Potenza, Marc N; Miyasaki, Janis; Siderowf, Andrew D; Duda, John E; Hurtig, Howard I; Colcher, Amy; Horn, Stacy S; Stern, Matthew B; Voon, Valerie

    2009-07-30

    As no comprehensive assessment instrument for impulse control disorders (ICDs) in Parkinson's disease (PD) exists, the aim of this study was to design and assess the psychometric properties of a self-administered screening questionnaire for ICDs and other compulsive behaviors in PD. The Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease (QUIP) has 3 sections: Section 1 assesses four ICDs (involving gambling, sexual, buying, and eating behaviors), Section 2 other compulsive behaviors (punding, hobbyism, and walkabout), and Section 3 compulsive medication use. For validation, a convenience sample of 157 PD patients at 4 movement disorders centers first completed the QUIP, and then was administered a diagnostic interview by a trained rater blinded to the QUIP results. A shortened instrument (QUIP-S) was then explored. The discriminant validity of the QUIP was high for each disorder or behavior (receiver operating characteristic area under the curve [ROC AUC]: gambling = 0.95, sexual behavior = 0.97, buying = 0.87, eating = 0.88, punding = 0.78, hobbyism = 0.93, walkabout = 0.79). On post hoc analysis, the QUIP-S ICD section had similar properties (ROC AUC: gambling = 0.95, sexual behavior = 0.96, buying = 0.87, eating = 0.88). When disorders/behaviors were combined, the sensitivity of the QUIP and QUIP-S to detect an individual with any disorder was 96 and 94%, respectively. Scores on the QUIP appear to be valid as a self-assessment screening instrument for a range of ICDs and other compulsive behaviors that occur in PD, and a shortened version may perform as well as the full version. A positive screen should be followed by a comprehensive, clinical interview to determine the range and severity of symptoms, as well as need for clinical management. Copyright 2009 Movement Disorder Society.

  15. Risk factors for suicide completion in major depression: a case-control study of impulsive and aggressive behaviors in men.

    Science.gov (United States)

    Dumais, A; Lesage, A D; Alda, M; Rouleau, G; Dumont, M; Chawky, N; Roy, M; Mann, J J; Benkelfat, C; Turecki, Gustavo

    2005-11-01

    Major depression is a major risk factor for suicide. However, not all individuals with major depression commit suicide. Impulsive and aggressive behaviors have been proposed as risk factors for suicide, but it remains unclear whether their effect on the risk of suicide is at least partly explained by axis I disorders commonly associated with suicide, such as major depression. With a case-control design, a comparison of the level of impulsive and aggressive behaviors and the prevalence of associated psychopathology was carried out with control for the presence of primary psychopathology. One hundred and four male suicide completers who died during an episode of major depression and 74 living depressed male comparison subjects were investigated with proxy-based interviews by using structured diagnostic instruments and personality trait assessments. The authors found that current (6-month prevalence) alcohol abuse/dependence, current drug abuse/dependence, and cluster B personality disorders increased the risk of suicide in individuals with major depression. Also, higher levels of impulsivity and aggression were associated with suicide. An analysis by age showed that these risk factors were more specific to younger suicide victims (ages 18-40). A multivariate analysis indicated that current alcohol abuse/dependence and cluster B personality disorder were two independent predictors of suicide. Impulsive-aggressive personality disorders and alcohol abuse/dependence were two independent predictors of suicide in major depression, and impulsive and aggressive behaviors seem to underlie these risk factors. A developmental hypothesis of suicidal behavior, with impulsive and aggressive behaviors as the starting point, is discussed.

  16. Impulsive control of a financial model [rapid communication

    Science.gov (United States)

    Sun, Jitao; Qiao, Fei; Wu, Qidi

    2005-02-01

    In this Letter, several new theorems on the stability of impulsive control systems are presented. These theorem are then used to find the conditions under which an advertising strategy can be asymptotically control to the equilibrium point by using impulsive control. Given the parameters of the financial model and the impulsive control law, an estimation of the upper bound of the impulse interval is given, i.e., number of advert can been decreased (i.e., can decrease cost) for to obtain the equivalent advertising effect.The result is illustrated to be efficient through a numerical example.

  17. Arousal, Executive Control and Decision Making in Compulsive Buying Disorder

    DEFF Research Database (Denmark)

    Ramsøy, Thomas Zöega; Zuraigat, Farah Qureshi; Jacobsen, Catrine

    2013-01-01

    Compulsive buying disorder (CBD) is noted by an obsession with shopping and a chronic, repetitive purchasing behavior with adverse consequences for the sufferer and their social surroundings. While CBD is often classified as an impulse control disorder (ICD), little is still known about the actua......, products of interest (e.g. fashion items) produce bottom-up emotional responses that skews the decision-making process, leading CBD sufferers to make bad purchase decisions.......Compulsive buying disorder (CBD) is noted by an obsession with shopping and a chronic, repetitive purchasing behavior with adverse consequences for the sufferer and their social surroundings. While CBD is often classified as an impulse control disorder (ICD), little is still known about the actual...

  18. Lamotrigine use in patients with binge eating and purging, significant affect dysregulation, and poor impulse control.

    Science.gov (United States)

    Trunko, Mary Ellen; Schwartz, Terry A; Marzola, Enrica; Klein, Angela S; Kaye, Walter H

    2014-04-01

    Some patients with symptoms of binge eating and purging are successfully treated with specific serotonin reuptake inhibitors (SSRIs), but others experience only partial or no benefit. Significant affect dysregulation and poor impulse control may be characteristics that limit responsiveness. We report on the treatment of five patients with bulimia nervosa (BN), anorexia nervosa-binge/purge type (AN-B/P) or eating disorder not otherwise specified (EDNOS), using the anticonvulsant lamotrigine after inadequate response to SSRIs. Following addition of lamotrigine to an antidepressant in four cases, and switch from an antidepressant to lamotrigine in one case, patients experienced substantial improvement in mood reactivity and instability, impulsive drives and behaviors, and eating-disordered symptoms. These findings raise the possibility that lamotrigine, either as monotherapy or as an augmenting agent to antidepressants, may be useful in patients who binge eat and purge, and have significant affect dysregulation with poor impulse control. Copyright © 2013 Wiley Periodicals, Inc.

  19. Higher Impulsivity As a Distinctive Trait of Severe Cocaine Addiction among Individuals Treated for Cocaine or Alcohol Use Disorders

    Directory of Open Access Journals (Sweden)

    Nuria García-Marchena

    2018-02-01

    Full Text Available AimsDespite alcohol being the most often used addictive substance among addicted patients, use of other substances such as cocaine has increased over recent years, and the combination of both drugs aggravates health impairment and complicates clinical assessment. The aim of this study is to identify and characterize heterogeneous subgroups of cocaine- and alcohol-addicted patients with common characteristics based on substance use disorders, psychiatric comorbidity and impulsivity.MethodsA total of 214 subjects with cocaine and/or alcohol use disorders were recruited from outpatient treatment programs and clinically assessed. A latent class analysis was used to establish phenotypic categories according to diagnosis of cocaine and alcohol use disorders, mental disorders, and impulsivity scores. Relevant variables were examined in the latent classes (LCs using correlation and analyses of variance and covariance.ResultsFour LCs of addicted patients were identified: Class 1 (45.3% formed by alcohol-dependent patients exhibiting lifetime mood disorder diagnosis and mild impulsivity; Class 2 (14% formed mainly by lifetime cocaine use disorder patients with low probability of comorbid mental disorders and mild impulsivity; Class 3 (10.7% formed by cocaine use disorder patients with elevated probability to course with lifetime anxiety, early and personality disorders, and greater impulsivity scores; and Class 4 (29.9% formed mainly by patients with alcohol and cocaine use disorders, with elevated probability in early and personality disorders and elevated impulsivity. Furthermore, there were significant differences among classes in terms of Diagnostic and Statistical Manual of Mental Disorders-4th Edition-Text Revision criteria for abuse and dependence: Class 3 showed more criteria for cocaine use disorders than other classes, while Class 1 and Class 4 showed more criteria for alcohol use disorders.ConclusionCocaine- and alcohol-addicted patients who

  20. Minimal Time Problem with Impulsive Controls

    Energy Technology Data Exchange (ETDEWEB)

    Kunisch, Karl, E-mail: karl.kunisch@uni-graz.at [University of Graz, Institute for Mathematics and Scientific Computing (Austria); Rao, Zhiping, E-mail: zhiping.rao@ricam.oeaw.ac.at [Austrian Academy of Sciences, Radon Institute of Computational and Applied Mathematics (Austria)

    2017-02-15

    Time optimal control problems for systems with impulsive controls are investigated. Sufficient conditions for the existence of time optimal controls are given. A dynamical programming principle is derived and Lipschitz continuity of an appropriately defined value functional is established. The value functional satisfies a Hamilton–Jacobi–Bellman equation in the viscosity sense. A numerical example for a rider-swing system is presented and it is shown that the reachable set is enlargered by allowing for impulsive controls, when compared to nonimpulsive controls.

  1. Comparison of personality characteristics in Parkinson disease patients with and without impulse control disorders and in healthy volunteers.

    Science.gov (United States)

    Farnikova, Katerina; Obereigneru, Radko; Kanovsky, Petr; Prasko, Jan

    2012-03-01

    We aimed to assess personality characteristics in patients with Parkinson disease (PD) with and without impulse control disorders (ICD). We tested patients and controls with the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) scales that have expected high sensitivity to apparent addictive behavior. We recorded mean disease duration and mean levodopa dose in the PD groups. Of the 46 PD patients, 13 had ICD: hypersexuality, binge eating, or dopamine dysregulation. The PD patients with ICD had a longer duration of disease (11 vs. 5 y) and were taking higher doses of levodopa (900 vs. 500 mg/d). They scored above the pathologic threshold in 4 domains of the MMPI-2 Clinical Scales and in 8 Clinical Subscales and Content Scales. The most significant abnormality was Alienation-Self and Others. ICDs in the general population have similarities to disorders of substance addiction. In PD patients, some personality profiles could play a role in development of ICDs or dopamine dysregulation syndrome. The MMPI-2 may be a useful test for PD patients in general, and for detecting ICD in particular.

  2. Individual Differences in Cognitive Control Circuit Anatomy Link Sensation Seeking, Impulsivity, and Substance Use

    Science.gov (United States)

    Hollinshead, Marisa O.; Roffman, Joshua L.; Smoller, Jordan W.; Buckner, Randy L.

    2016-01-01

    , and predicted heightened alcohol, tobacco, and caffeine use. These data indicate that normal variability in cognitive control system anatomy predicts sensation seeking and motor impulsivity in the healthy populations, potentially increasing risk for substance use disorders. PMID:27053210

  3. Behavioral Impulsivity and Risk-Taking Trajectories Across Early Adolescence in Youths With and Without Family Histories of Alcohol and Other Drug Use Disorders.

    Science.gov (United States)

    Dougherty, Donald M; Lake, Sarah L; Mathias, Charles W; Ryan, Stacy R; Bray, Bethany C; Charles, Nora E; Acheson, Ashley

    2015-08-01

    Youths with family histories of alcohol and other drug use disorders (FH+) are at increased susceptibility for developing substance use disorders relative to those without such histories (FH-). This vulnerability may be related to impaired adolescent development of impulse control and elevated risk-taking. However, no previous studies have prospectively examined impulse control and risk-taking in FH+ youth across adolescence. A total of 386 pre-adolescents (305 FH+, 81 FH-; aged 10 to 12) with no histories of regular alcohol or other drug use were compared on behavioral measures of impulsivity including delay discounting, response initiation (Immediate Memory Task), response inhibition impulsivity (GoStop Impulsivity Paradigm), and risk-taking (Balloon Analogue Risk Task-Youth). Youths completed these laboratory tasks every 6 months, allowing for the examination of 10- to 15-year-olds. Hierarchical linear modeling was used to characterize the development of impulse control and risk-taking as shown in performance of these tasks throughout adolescence. We found that (i) FH+ youths had increased levels of delay discounting and response inhibition impulsivity at study entry; (ii) regardless of FH status, all youths had relatively stable delay discounting across time, improvements in response inhibition and response initiation impulsivity, and increased risk-taking; and (iii) although FH+ youths had increased response inhibition impulsivity at pre-adolescence, these differences were negligible by mid-adolescence. Heightened delay discounting in FH+ pre-adolescents coupled with normal adolescent increases in risk-taking may contribute to their increased susceptibility toward problem substance use in adolescence. Copyright © 2015 by the Research Society on Alcoholism.

  4. Frontal-striatal abnormalities underlying behaviours in the compulsive-impulsive spectrum

    NARCIS (Netherlands)

    van den Heuvel, Odile A.; der Werf, Ysbrand D. van; Verhoef, Kim M. W.; de Wit, Stella; Berendse, Henk W.; Wolters, Erik Ch; Veltman, Dick J.; Groenewegen, Henk J.

    2010-01-01

    In this paper, we tentatively bring together the psychiatric, neurological and addiction perspectives on the impulsive-compulsive spectrum of neuropsychiatric disorders, in order to understand the pathophysiology of impulse control disorders (ICDs) in Parkinson's disease. In an attempt to try to

  5. Chaotification of complex networks with impulsive control.

    Science.gov (United States)

    Guan, Zhi-Hong; Liu, Feng; Li, Juan; Wang, Yan-Wu

    2012-06-01

    This paper investigates the chaotification problem of complex dynamical networks (CDN) with impulsive control. Both the discrete and continuous cases are studied. The method is presented to drive all states of every node in CDN to chaos. The proposed impulsive control strategy is effective for both the originally stable and unstable CDN. The upper bound of the impulse intervals for originally stable networks is derived. Finally, the effectiveness of the theoretical results is verified by numerical examples.

  6. Overlapping and disease specific aspects of impulsivity in children and adolescents with schizophrenia spectrum disorders or Attention-Deficit/Hyperactivity Disorder

    DEFF Research Database (Denmark)

    Jepsen, Jens Richardt Møllegaard; Rydkjær, Jacob; Fagerlund, Birgitte

    Objectives: To identify disease specific and overlapping aspects of impulsivity in children and adolescents with early-onset schizophrenia spectrum disorders or ADHD. Methods: Motor impulsivity (Stop Signal Task), reflection impulsivity (Information Sampling Task), and trait impulsivity (Barratt ...... their decision making to gather more information in a condition with a conflict between reward and certainty. The reduced information sampling may also reflect an increased conviction in the decision at a point of relative uncertainty....

  7. Self-reported impulsivity and inhibitory control in problem gamblers.

    Science.gov (United States)

    Lorains, Felicity K; Stout, Julie C; Bradshaw, John L; Dowling, Nicki A; Enticott, Peter G

    2014-01-01

    Impulsivity is considered a core feature of problem gambling; however, self-reported impulsivity and inhibitory control may reflect disparate constructs. We examined self-reported impulsivity and inhibitory control in 39 treatment-seeking problem gamblers and 41 matched controls using a range of self-report questionnaires and laboratory inhibitory control tasks. We also investigated differences between treatment-seeking problem gamblers who prefer strategic (e.g., sports betting) and nonstrategic (e.g., electronic gaming machines) gambling activities. Treatment-seeking problem gamblers demonstrated elevated self-reported impulsivity, more go errors on the Stop Signal Task, and a lower gap score on the Random Number Generation task than matched controls. However, overall we did not find strong evidence that treatment-seeking problem gamblers are more impulsive on laboratory inhibitory control measures. Furthermore, strategic and nonstrategic problem gamblers did not differ from their respective controls on either self-reported impulsivity questionnaires or laboratory inhibitory control measures. Contrary to expectations, our results suggest that inhibitory dyscontrol may not be a key component for some treatment-seeking problem gamblers.

  8. Video game therapy for emotional regulation and impulsivity control in a series of treated cases with bulimia nervosa.

    Science.gov (United States)

    Fagundo, Ana B; Santamaría, Juan J; Forcano, Laura; Giner-Bartolomé, Cristina; Jiménez-Murcia, Susana; Sánchez, Isabel; Granero, Roser; Ben-Moussa, Maher; Magnenat-Thalmann, Nadia; Konstantas, Dimitri; Lam, Tony; Lucas, Mikkel; Nielsen, Jeppe; Bults, Richard G A; Tarrega, Salomé; Menchón, José M; de la Torre, Rafael; Cardi, Valentina; Treasure, Janet; Fernández-Aranda, Fernando

    2013-11-01

    Although standard psychological treatments have been successful in treating several core features in eating disorders (ED), other characteristics such as emotional regulation or impulsivity appear to be more resistant to change. There is a growing body of evidence to support the efficacy of cognitive remediation for cognitive and emotional difficulties in ED. Playmancer/ Islands is a video game (VG) designed to specifically treat mental disorders, characterized by problems in impulse control. The objective of the game is to increase self-control over emotions, decision making and behaviours. The aim of this study is to describe the results from a consecutive series of nine bulimia nervosa patients who were treated with the VG in addition to cognitive behaviour therapy (CBT). The outcomes included clinical and psychopathological questionnaires, and physiological measures were obtained during the VG. Emotional regulation improved, heart rate variability increased, and respiratory rate and impulsivity measures reduced after the treatment. These findings suggest that VG training may enhance treatment for ED. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.

  9. Impulsivity and decision-making in obsessive-compulsive disorder after effective deep brain stimulation or treatment as usual.

    Science.gov (United States)

    Grassi, Giacomo; Figee, Martijn; Ooms, Pieter; Righi, Lorenzo; Nakamae, Takashi; Pallanti, Stefano; Schuurman, Rick; Denys, Damiaan

    2018-06-04

    Impulsivity and impaired decision-making have been proposed as obsessive-compulsive disorder (OCD) endophenotypes, running in OCD and their healthy relatives independently of symptom severity and medication status. Deep brain stimulation (DBS) targeting the ventral limb of the internal capsule (vALIC) and the nucleus accumbens (Nacc) is an effective treatment strategy for treatment-refractory OCD. The effectiveness of vALIC-DBS for OCD has been linked to its effects on a frontostriatal network that is also implicated in reward, impulse control, and decision-making. While vALIC-DBS has been shown to restore reward dysfunction in OCD patients, little is known about the effects of vALIC-DBS on impulsivity and decision-making. The aim of the study was to compare cognitive impulsivity and decision-making between OCD patients undergoing effective vALIC-DBS or treatment as usual (TAU), and healthy controls. We used decision-making performances under ambiguity on the Iowa Gambling Task and reflection impulsivity on the Beads Task to compare 20 OCD patients effectively treated with vALIC-DBS, 40 matched OCD patients undergoing effective TAU (medication and/or cognitive behavioural therapy), and 40 healthy subjects. Effective treatment was defined as at least 35% improvement of OCD symptoms. OCD patients, irrespective of treatment modality (DBS or TAU), showed increased reflection impulsivity and impaired decision-making compared to healthy controls. No differences were observed between OCD patients treated with DBS or TAU. OCD patients effectively treated with vALIC-DBS or TAU display increased reflection impulsivity and impaired decision-making independent of the type of treatment.

  10. Neuroanatomical and Neurochemical Basis of Impulsivity

    Directory of Open Access Journals (Sweden)

    Kemal Yazici

    2010-08-01

    Full Text Available The term ‘impulsivity’ encompasses a multitude of behaviours that are poorly conceived, premature, inappropriate, and that frequently result in unwanted or deleterious outcomes. Impulsivity manifests as impatience carelessness, risk-taking, sensation-seeking and pleasure-seeking, an underestimated sense of harm, and extroversion. Impulsivity is a core symptom of a broad spectrum of psychiatric disorders. Through focusing on different aspects of impulsive behavior, it has proved possible to devise a variety of behavioral paradigms to measure impulsivity in both human and non-human subjects. These can be broadly divided into two categories: those measuring impulsive action or motoric impulsivity, and those measuring impulsive choice or impulsive decision-making. Impulsive action can be broadly defined as the inability to withhold from making a response. Within the framework of behavioral neuroscience and cognitive psychology, impulse control has been described as an active inhibitory mechanism which modulates the internally or externally driven pre-potent desire for primary reinforcers such as food, sex or other highly desirable rewards. This inhibitory control mechanism may provide the substrate by which rapid conditioned responses and reflexes are transiently suppressed, so that slower cognitive mechanisms can guide behavior. This process is referred to as response inhibition. Two of the most common tests used to study inhibitory processes are the go/no-go and stop-signal reaction time tasks. Impulsivity is also evident in the making of impulsive decisions or choices as well as in impulsive actions. Here, there is no “pre-potent” response that is primed and then forcibly inhibited, but a decision-making processes. Impulsive decision making or impulsive choice is defined as initiating actions without adequately considering other possible choices or consequences. Impulsive choice is typically measured in the delay discounting paradigm. In

  11. An Impulse Control Disorder Case with Penile Fracture and Trichotillomania

    OpenAIRE

    CUMURCU, Birgül ELBOZAN

    2014-01-01

    Penile fractures are classically described as presenting with rapid detumescence of an erection associated with blunt trauma. This clinical finding is due to a tear in the tunica albuginea surrounding the corpora cavernosum. In this study, we report and discuss a case of trichotillomania and penile bending impulse resulting in penile fracture, which was operated in the urology clinic. The possible psychological and psychiatric problems underlying the impulsive behavior are discussed, and the ...

  12. Externalizing behavior and impulsivity in the children of alcoholics: A case-control study

    Directory of Open Access Journals (Sweden)

    Ayyanar Sugaparaneetharan

    2016-01-01

    Full Text Available Context: Reduced behavioural inhibition, characterized by impulsivity and disruptive behaviour disorders, has been identified as a developmental precursor of alcoholism with a considerable genetic component. Aims: The present study aimed to assess whether children of fathers with alcohol dependence have high impulsivity and externalizing behaviours. Setting and Design: Observational case-control study, done in a tertiary care teaching hospital of Southern India. Materials and Methods: The present case-control study recruited 50 children aged 7 to 14 years of fathers with alcohol dependence and 50 age- and gender-matched children of fathers without alcohol dependence. The two groups were compared using the DSM-IV-TR criteria for ADHD, the Barratt Impulsivity Scale (BIS and the Child Behaviour Checklist (CBCL. Statistical Analysis Used: Descriptive statistics used to summarise the study findings. Cases and controls were compared on BIS and CBCL scores using a general linear model (GLM. All analyses were two tailed and test P value <0.05 was considered significant. Results: The children of fathers with alcohol dependence were more likely to meet criteria for ADHD (30% versus 10%, χ2 = 6.250, P = 0.012. After controlling for age and gender, impulsivity scores on the BIS tended to be higher in the cases (F = 2.410, P = 0.055 than controls, mainly in the non-planning domains (F = 3.650, P = 0.008. Similarly, externalizing behaviours on CBCL were more common in the cases than controls (F = 2.817, P = 0.029. Conclusions: Children of fathers with alcohol dependence had greater impulsivity and externalizing behaviours. This may represent a behavioural phenotype as well as a potential target for early intervention.

  13. The risky business of dopamine agonists in Parkinson disease and impulse control disorders.

    Science.gov (United States)

    Claassen, Daniel O; van den Wildenberg, Wery P M; Ridderinkhof, K Richard; Jessup, Charles K; Harrison, Madaline B; Wooten, G Frederick; Wylie, Scott A

    2011-08-01

    Risk-taking behavior is characterized by pursuit of reward in spite of potential negative consequences. Dopamine neurotransmission along the mesocorticolimbic pathway is a potential modulator of risk behavior. In patients with Parkinson's disease (PD), impulse control disorder (ICD) can result from dopaminergic medication use, particularly dopamine agonists (DAA). Behaviors associated with ICD include hypersexuality as well as compulsive gambling, shopping, and eating, and these behaviors are potentially linked to alterations to risk processing. Using the Balloon Analogue Risk Task, we assessed the role of agonist therapy on risk-taking behavior in PD patients with (n = 22) and without (n = 19) active ICD symptoms. Patients performed the task both "on" and "off" DAA. DAA increased risk-taking in PD patients with active ICD symptoms, but it did not affect risk behavior of PD controls. DAA dose was also important in explaining risk behavior. Both groups similarly reduced their risk-taking in high compared to low risk conditions and following the occurrence of a negative consequence, suggesting that ICD patients do not necessarily differ in their abilities to process and adjust to some aspects of negative consequences. Our findings suggest dopaminergic augmentation of risk-taking behavior as a potential contributing mechanism for the emergence of ICD in PD patients. (PsycINFO Database Record (c) 2011 APA, all rights reserved).

  14. Beyond discounting: possible experimental models of impulse control.

    Science.gov (United States)

    Monterosso, J; Ainslie, G

    1999-10-01

    Animal studies of impulsivity have typically used one of three models: a delay of reward procedure, a differential reinforcement for low rate responding (DRL) procedure, or an autoshaping procedure. In each of these paradigms, we argue, measurement of impulsivity is implicitly or explicitly equated with the effect delay has on the value of reward. The steepness by which delay diminishes value (the temporal discount function) is treated as an index of impulsivity. In order to provide a better analog of human impulsivity, this model needs to be expanded to include the converse of impulsivity - self-control. Through mechanisms such as committing to long range interests before the onset of temptation, or through bundling individual choices into classes of choices that are made at once, human decision-making can often look far less myopic than single trial experiments predict. For people, impulsive behavior may be more often the result of the breakdown of self-control mechanisms than of steep discount functions. Existing animal models of self-control are discussed, and future directions are suggested for psychopharmacological research.

  15. The differences in temperament–character traits, suicide attempts, impulsivity, and functionality levels of patients with bipolar disorder I and II

    Directory of Open Access Journals (Sweden)

    Izci F

    2016-01-01

    Full Text Available Filiz Izci,1 Ebru Kanmaz Findikli,2 Serkan Zincir,3 Selma Bozkurt Zincir,4 Merve Iris Koc4 1Department of Psychiatry, School of Medicine, Istanbul Bilim University, Istanbul, 2Department of Psychiatry, School of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, 3Department of Psychiatry, Kocaeli Gölcük Military Hospital, Kocaeli, 4Department of Psychiatry, Erenköy Training and Research Hospital for Psychiatric and Neurological Disorders, Istanbul, Turkey Background: The primary aim of this study was to compare the differences in temperament-character traits, suicide attempts, impulsivity, and functionality levels of patients with bipolar disorder I (BD-I and bipolar disorder II (BD-II.Methods: Fifty-two BD-I patients and 49 BD-II patients admitted to Erenköy Mental and Neurological Disease Training and Research Hospital psychiatry clinic and fifty age- and sex-matched healthy control subjects were enrolled in this study. A structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition Axis I Disorders, Temperament and Character Inventory, Barrett Impulsiveness Scale-11 (BIS-11, Hamilton Depression Inventory Scale, Young Mania Rating Scale, and Bipolar Disorder Functioning Questionnaire (BDFQ were administered to patients and to control group.Results: No statistically significant difference in sociodemographic features existed between the patient and control groups (P>0.05. Thirty-eight subjects (37.62% in the patient group had a suicide attempt. Twenty-three of these subjects (60.52% had BD-I, and 15 of these subjects (39.47% had BD-II. Suicide attempt rates in BD-I and II patients were 60.52% and 39.47%, respectively (P<0.05. Comparison of BD-I and II patients with healthy control subjects revealed that cooperativeness (C, self-directedness (Sdi, and self-transcendence (ST scores were lower and novelty seeking (NS1 and NS2, harm avoidance (HA4, and reward dependence (RD2 subscale scores

  16. Assessing the role of impulsivity in smoking & non-smoking disordered gamblers.

    Science.gov (United States)

    Boothby, Célina A; Kim, Hyoun S; Romanow, Nicole K; Hodgins, David C; McGrath, Daniel S

    2017-07-01

    Co-morbidity with other addictive behaviors is common in disordered gambling (DG). In particular, tobacco dependence has been found to be among the most prevalent disorders co-morbid with DG. While the extant literature has firmly established the co-occurrence of DG and smoking, there is a paucity of research examining factors that differentiate DGs who smoke from those who do not. To address this empirical gap, the current study tested whether dimensions of trait impulsivity as measured by the UPPS-P Impulsive Behavior Scale (positive urgency, negative urgency, lack of premeditation, lack of perseverance, and sensation seeking), discriminated between non-DGs and DGs based on their present smoking status: non-smoker, occasional smoker, and daily smoker. To this end, 564 community gamblers were recruited through a crowdsourcing platform (Amazon's Mechanical Turk) and completed an online survey, assessing problem gambling severity, tobacco use, and trait impulsivity. MANOVA analyses revealed significant main effects for both gambling severity and smoking status groups. Importantly, a significant gambling by smoking interaction was also found. Pairwise comparisons revealed that DGs who were daily smokers scored higher on negative urgency than those who smoked occasionally or not all. Furthermore, among non-DGs, smoking status failed to discriminate between mean scores on negative urgency. No other significant interaction effects were found for the remaining UPPS-P impulsivity facets. Results suggest that individual components of trait impulsivity, and more specifically negative urgency, successfully differentiate DGs who do not smoke, or just smoke occasionally, from DGs who smoke daily. These findings suggest that the degree of trait impulsivity may potentially distinguish between DGs and DGs who are dually addicted to other substances such as tobacco. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. A cross-sectional examination of non-suicidal self-injury, disordered eating, impulsivity, and compulsivity in a sample of adult women.

    Science.gov (United States)

    Black, Emma B; Mildred, Helen

    2014-12-01

    Non-suicidal self-injury has been classed as having both impulsive and compulsive characteristics (Simeon & Favazza, 2001). These constructs have been related to disordered eating behaviors such as vomiting (Favaro & Santonastaso, 1998). Utilizing an international sample of adult females, this paper further explored this model, aiming to identify whether all types of disordered eating could be classified as impulsive or compulsive, and whether the impulsive and compulsive groupings reflect underlying trait impulsivity and compulsivity. The hypothesized impulsive and compulsive dimensions did not emerge from the data. Notably however, all self-injurious and disordered eating behaviors were linked to Urgency (an impulsivity facet) to varying degrees; no relationship with trait compulsivity was found. These findings are discussed, study limitations are noted, and relevance for clinical practice is outlined.

  18. Impulse control disorders in Parkinson's disease are associated with dysfunction in stimulus valuation but not action valuation.

    Science.gov (United States)

    Piray, Payam; Zeighami, Yashar; Bahrami, Fariba; Eissa, Abeer M; Hewedi, Doaa H; Moustafa, Ahmed A

    2014-06-04

    A substantial subset of Parkinson's disease (PD) patients suffers from impulse control disorders (ICDs), which are side effects of dopaminergic medication. Dopamine plays a key role in reinforcement learning processes. One class of reinforcement learning models, known as the actor-critic model, suggests that two components are involved in these reinforcement learning processes: a critic, which estimates values of stimuli and calculates prediction errors, and an actor, which estimates values of potential actions. To understand the information processing mechanism underlying impulsive behavior, we investigated stimulus and action value learning from reward and punishment in four groups of participants: on-medication PD patients with ICD, on-medication PD patients without ICD, off-medication PD patients without ICD, and healthy controls. Analysis of responses suggested that participants used an actor-critic learning strategy and computed prediction errors based on stimulus values rather than action values. Quantitative model fits also revealed that an actor-critic model of the basal ganglia with different learning rates for positive and negative prediction errors best matched the choice data. Moreover, whereas ICDs were associated with model parameters related to stimulus valuation (critic), PD was associated with parameters related to action valuation (actor). Specifically, PD patients with ICD exhibited lower learning from negative prediction errors in the critic, resulting in an underestimation of adverse consequences associated with stimuli. These findings offer a specific neurocomputational account of the nature of compulsive behaviors induced by dopaminergic drugs. Copyright © 2014 the authors 0270-6474/14/347814-11$15.00/0.

  19. Self-Instructional Cognitive Training to Reduce Impulsive Cognitive Style in Children with Attention Deficit with Hyperactivity Disorder

    Science.gov (United States)

    Rivera-Flores, Gladys Wilma

    2015-01-01

    Introduction: Children with attention deficit with hyperactivity disorder (ADHD) have an impulsive, rigid and field-dependent cognitive style. This study examines whether self-instructional cognitive training reduces impulsive cognitive style in children diagnosed with this disorder. Method: The subjects were 10 children between the ages of 6 and…

  20. Impulsive Behaviors in Patients With Pathological Buying.

    Science.gov (United States)

    Zander, Heike; Claes, Laurence; Voth, Eva M; de Zwaan, Martina; Müller, Astrid

    2016-09-01

    Aim To investigate impulsive behaviors in pathological buying (PB). Methods The study included three groups matched for age and gender: treatment seeking outpatients with PB (PB+), treatment seeking psychiatric inpatients without PB (PB-), and a healthy control group (HC). PB was assessed by means of the Compulsive Buying Scale and by the impulse control disorder (ICD) module of the research version of the Structured Clinical Interview for DSM-IV (SCID-ICD). All participants answered questionnaires concerning symptoms of borderline personality disorder, self-harming behaviors, binge eating and symptoms of attention deficit and hyperactivity disorder (ADHD). In addition, comorbid ICDs were assessed using the SCID-ICD. Results The PB+ and PB- groups did not differ with regard to borderline personality disorder or ADHD symptoms, but both groups reported significantly more symptoms than the HC group. Frequencies of self-harming behaviors did not differ between the three groups. Patients with PB were more often diagnosed with any current ICD (excluding PB) compared to those without PB and the HC group (38.7% vs. 12.9% vs. 12.9%, respectively, p=.017). Discussion Our findings confirm prior research suggesting more impulsive behaviors in patients with and without PB compared to healthy controls. The results of the questionnaire-based assessment indicate that outpatients with PB perceive themselves equally impulsive and self-harm as frequently as inpatients without PB; but they seem to suffer more often from an ICD as assessed by means of an interview.

  1. Impulse control behaviors and subthalamic deep brain stimulation in Parkinson disease.

    Science.gov (United States)

    Merola, Aristide; Romagnolo, Alberto; Rizzi, Laura; Rizzone, Mario Giorgio; Zibetti, Maurizio; Lanotte, Michele; Mandybur, George; Duker, Andrew P; Espay, Alberto J; Lopiano, Leonardo

    2017-01-01

    To determine the clinical and demographic correlates of persistent, remitting, and new-onset impulse control behaviors (ICBs) before and after subthalamic deep brain stimulation (STN-DBS) in Parkinson's disease (PD). We compared the pre- and post-surgical prevalence of ICBs, classified as impulse control disorders (ICD), dopamine dysregulation syndrome (DDS), and punding in 150 consecutive PD STN-DBS-treated patients and determined the association with motor, cognitive, neuropsychological, and neuropsychiatric endpoints. At baseline (before STN-DBS), ICBs were associated with younger age (p = 0.045) and male gender (85 %; p = 0.001). Over an average follow-up of 4.3 ± 2.1 years of chronic STN-DBS there was an overall trend for reduction in ICBs (from 17.3 to 12.7 %; p = 0.095) with significant improvement in hypersexuality (12-8.0 %; p = 0.047), gambling (10.7-5.3 %; p = 0.033), and DDS (4.7-0 %; p disorders; persistent ICB in those with obsessive-compulsive traits. PD-related ICBs exhibit a complex outcome after STN-DBS, with a tendency for overall reduction but with age, gender, dopaminergic therapy, and neuropsychiatric features exerting independent effects.

  2. Diet-induced impulsivity: Effects of a high-fat and a high-sugar diet on impulsive choice in rats.

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    Steele, Catherine C; Pirkle, Jesseca R A; Kirkpatrick, Kimberly

    2017-01-01

    Impulsive choice is a common charactertistic among individuals with gambling problems, obesity, and substance abuse issues. Impulsive choice has been classified as a trans-disease process, and understanding the etiology of trait impulsivity could help to understand how diseases and disorders related to impulsive choice are manifested. The Western diet is a possible catalyst of impulsive choice as individuals who are obese and who eat diets high in fat and sugar are typically more impulsive. However, such correlational evidence is unable to discern the direction and causal nature of the relationship. The present study sought to determine how diet may directly contribute to impulsive choice. After 8 weeks of dietary exposure (high-fat, high-sugar, chow), the rats were tested on an impulsive choice task, which presented choices between a smaller-sooner reward (SS) and a larger-later reward (LL). Then, the rats were transferred to a chow diet and retested on the impulsive choice task. The high-sugar and high-fat groups made significantly more impulsive choices than the chow group. Both groups became more self-controlled when they were off the diet, but there were some residual effects of the diet on choice behavior. These results suggest that diet, specifically one high in processed fat or sugar, induces impulsive choice. This diet-induced impulsivity could be a precursor to other disorders that are characterized by impulsivity, such as diet-induced obesity, and could offer potential understanding of the trans-disease nature of impulsive choice.

  3. Impulsivity and test meal intake among women with bulimia nervosa.

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    Sysko, Robyn; Ojserkis, Rachel; Schebendach, Janet; Evans, Suzette M; Hildebrandt, Tom; Walsh, B Timothy

    2017-05-01

    Many patients with bulimia nervosa (BN) also meet criteria for a lifetime alcohol use disorder (AUD). In order to understand possible mechanisms contributing to the co-occurrence and perpetuation of these disorders, this study investigated the importance of impulsivity and test meal intake among patients with BN by comparing women with BN only (n = 18), BN and current/past AUDs (n = 13), and healthy controls (n = 12). All participants completed assessments of eating disorder symptoms, frequency of alcohol use, binge eating, and purging via questionnaires and semi-structured interviews over two sessions. Measures of impulsivity consisted of computerized and self-report measures, and laboratory test meals. Significant differences between individuals with BN with/without comorbid AUDs were not found for test meal intake, impulsivity measures, or self-reported psychological symptoms. As hypothesized, compared to healthy controls, individuals with BN had significantly higher scores on two subscales and the total score of the Barratt Impulsiveness Scale, a trait measure of impulsivity, and consumed significantly more calories in the binge instruction meal. Total Barratt Impulsiveness Scale scores were also significantly related to kcal consumed during the laboratory test meal when individuals were instructed to binge eat (BN groups). Data from this study add to the existing literature implicating impulsivity in the psychopathology of disorders of binge eating, including BN, and also support the use of laboratory meals as a symptom-specific measure of this trait in eating disorder populations. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. REM sleep behavior disorder: association with motor complications and impulse control disorders in Parkinson's disease.

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    Kim, Young Eun; Jeon, Beom S; Yang, Hui-Jun; Ehm, Gwanhee; Yun, Ji Young; Kim, Han-Joon; Kim, Jong-Min

    2014-10-01

    Clinical phenotypes such as old age, longer disease duration, motor disability, akineto-rigid type, dementia and hallucinations are known to be associated with REM sleep behavior disorder (RBD) in Parkinson's disease (PD). However, the relationship between motor fluctuations/impulse control and related behaviors (ICRB) and RBD is not clear. We designed this study to elucidate the clinical manifestations associated with RBD to determine the implications of RBD in PD. In a cross-sectional study, a total of 994 patients with PD were interviewed to determine the presence of RBD and their associated clinical features including motor complications and ICRB. Of the 944 patients, 578 (61.2%) had clinical RBD. When comparing the clinical features between patients with RBD (RBD group) and without RBD (non-RBD group), older age, longer disease duration, higher Hoehn and Yahr stage (H&Y stage), higher levodopa equivalent daily dose (LEDD), and the existence of wearing off, dyskinesia, freezing, and ICRB, especially punding, were associated with the RBD group compared to the non-RBD group (P < .05 in all). Multivariate analysis showed that motor complications including wearing off, peak dose dyskinesia, and diphasic dyskinesia were the only relevant factors for RBD after adjusting for age and disease duration. Motor complications and ICRB are more frequent in patients with RBD than in patients without RBD. In addition, motor complications are related to RBD even after adjusting for age and disease duration. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. The relationship between impulsivity and suicide among rural youths aged 15-35 years: a case-control psychological autopsy study.

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    Lin, Lin; Zhang, Jie; Zhou, Li; Jiang, Chao

    2016-01-01

    In China, the gender ratio of suicide rates did not match the Western patterns, which was higher for females than males. However, the rural men were at relatively high risk of suicide in Liaoning province. Impulsivity was an important factor of suicide behaviors, but there was a lack of studies in China. This research aimed to study the relationship between impulsive personality traits and suicidal behavior among Chinese rural youths. Suicides were consecutively sampled from six randomly selected counties in Liaoning Province in China. Between 2005 and 2007, a total of 162 suicide victims were enrolled in the study along with 162 community controls matched for age, gender, and location. The psychological autopsy method was used to collect data from informants knowledgeable about the selected suicide victims and controls. The results showed the suicide victims in the study were more likely to demonstrate dysfunctional impulsivity and less likely to demonstrate functional impulsivity compared with the controls. Mental disorders, acute negative life events, and dysfunctional impulsivity contributed to the risk of suicide; educational and functional impulsivity were protective factors. Suicide prevention efforts in rural China may address impulsivity.

  6. The temporal course and clinical correlates of subjective impulsivity in bipolar disorder as revealed through ecological momentary assessment.

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    Depp, Colin A; Moore, Raeanne C; Dev, Sheena I; Mausbach, Brent T; Eyler, Lisa T; Granholm, Eric L

    2016-03-15

    Impulsivity is frequently linked with bipolar disorder and is associated with mania and negative outcomes. The temporal dynamics of subjective impulsivity are unclear, in particular whether impulsivity precedes or follows changes in positive or negative affect. A total of 41 outpatients with bipolar disorder (I or II) were provided with mobile devices for 11 weeks and completed twice-daily surveys about affective states and subjective impulsivity. We examined the association between aggregate subjective impulsivity with baseline global cognitive function, suicide risk ratings, and medication adherence, as well as concurrent and lagged associations with momentary positive and negative affect ratings. A total of 2902 ratings were available across study subjects. Higher aggregate mean ratings of impulsivity were associated with worse baseline global cognitive function, prior suicide attempts, and self-reported problems with medication adherence, as well as more severe manic (but not depressive) symptoms. Time-lagged models indicated that greater negative affect, but not positive affect, predicted subsequent increases in subjective impulsivity, which, in turn, predicted diminished positive affect. Other measures of impulsivity with which to validate subjective ratings were unavailable and the sample was restricted to generally clinically stable outpatients. Subjective impulsivity as measured by daily monitoring was associated with worse cognitive function and self-rated medication adherence, and higher suicide risk ratings. Impulsivity may be a maladaptive strategy to regulate negative affect in bipolar disorder. Copyright © 2016. Published by Elsevier B.V.

  7. Think twice: Impulsivity and decision making in obsessive-compulsive disorder

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    Grassi, Giacomo; Pallanti, Stefano; Righi, Lorenzo; Figee, Martijn; Mantione, Mariska; Denys, Damiaan; Piccagliani, Daniele; Rossi, Alessandro; Stratta, Paolo

    2015-01-01

    Recent studies have challenged the anxiety-avoidance model of obsessive-compulsive disorder (OCD), linking OCD to impulsivity, risky-decision-making and reward-system dysfunction, which can also be found in addiction and might support the conceptualization of OCD as a behavioral addiction. Here, we

  8. Personality traits and suicide attempts with and without psychiatric disorders: analysis of impulsivity and neuroticism.

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    Bi, Bo; Liu, Wei; Zhou, Die; Fu, Xu; Qin, Xiaoxia; Wu, Jiali

    2017-08-15

    There is a critical need for empirical data concerning the association of personality traits and attempted suicide with and without psychiatric disorders in mainland China. The objective of the present study is to provide such data by determining the prevalence of psychiatric disorders and analyzing the levels of impulsivity and neuroticism among people who have attempted suicide, and to examine the association between these personality traits and suicide attempt in people with or without psychiatric disorders. We administered self-reported tests and clinical interviews to 196 people who have attempted suicide who were admitted to a hospital emergency room or our psychiatric settings after a suicide attempt. One hundred and fifty-six subjects (79.6%) met the criteria for Axis I disorders and eleven (6.6%) met the criteria Axis II personality disorders. Those who have attempted suicide who did not have psychiatric disorders exhibited a greater degree of background characteristics (e.g., high lethality, more interpersonal conflicts and more alcohol use), lower levels of suicidality (suicide risk, depressive symptoms) and differences of personality traits (e.g., more impulsive and less neuroticism) as compared to those who do have psychiatric disorders. Profile differences existed even after control for the stressful life event. Our findings suggest that some personality traits differ between people who have attempted suicide depending on whether or not they have psychiatric disorders. Based on these findings, investigating the impact of personality traits on suicidal behavior in therapeutic settings would provide critical data to improve patient treatment and outcomes.

  9. Impulsivity across the psychosis spectrum: Correlates of cortical volume, suicidal history, and social and global function.

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    Nanda, Pranav; Tandon, Neeraj; Mathew, Ian T; Padmanabhan, Jaya L; Clementz, Brett A; Pearlson, Godfrey D; Sweeney, John A; Tamminga, Carol A; Keshavan, Matcheri S

    2016-01-01

    Patients with psychotic disorders appear to exhibit greater impulsivity-related behaviors relative to healthy controls. However, the neural underpinning of this impulsivity remains uncertain. Furthermore, it remains unclear how impulsivity might differ or be conserved between psychotic disorder diagnoses in mechanism and manifestation. In this study, self-reported impulsivity, measured by Barratt Impulsiveness Scale (BIS), was compared between 305 controls (HC), 139 patients with schizophrenia (SZ), 100 with schizoaffective disorder (SZA), and 125 with psychotic bipolar disorder (PBP). In each proband group, impulsivity was associated with regional cortical volumes (using FreeSurfer analysis of T1 MRI scans), suicide attempt history, Global Assessment of Functioning (GAF), and Social Functioning Scale (SFS). BIS scores were found to differ significantly between participant groups, with SZA and PBP exhibiting significantly higher impulsivity than SZ, which exhibited significantly higher impulsivity than HC. BIS scores were significantly related to suicide attempt history, and they were inversely associated with GAF, SFS, and bilateral orbitofrontal cortex (OFC) volume in both SZA and PBP, but not SZ. These findings indicate that psychotic disorders, particularly those with prominent affective symptoms, are characterized by elevated self-reported impulsivity measures. Impulsivity's correlations with suicide attempt history, GAF, and SFS suggest that impulsivity may be a mediator of clinical outcome. The observed impulsivity-OFC correlations corroborate the importance of OFC deficits in impulsivity. These correlations' presence in SZA and PBP but not in SZ suggests that impulsivity may have different underlying mechanisms in affective and non-affective psychotic disorders. Copyright © 2015 Elsevier B.V. All rights reserved.

  10. Current psychiatric morbidity, aggression/impulsivity, and personality dimensions in child and adolescent suicide: a case-control study.

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    Renaud, Johanne; Berlim, Marcelo T; McGirr, Alexander; Tousignant, Michel; Turecki, Gustavo

    2008-01-01

    The present study was designed to evaluate psychiatric risk factors for child and adolescent suicide, and to determine the association between impulsive-aggressive and other personality traits, and suicide completion in this population. Psychiatric diagnoses, impulsive-aggressive and other personality traits were assessed in 55 child and adolescent suicide victims and 55 community controls using semi-structured proxy-based interviews and questionnaires. The most significant psychiatric risk factors associated with child and adolescent suicide were depressive disorders (OR=48.414, 95% CI 6.247-375.185), substance/alcohol abuse disorder (OR=5.365, 95% CI 1.434-20.076), and disruptive disorders (OR=13.643, 95% CI 2.292-23.16). Additionally, suicide victims showed higher scores on lifetime aggression/impulsivity, and harm avoidance. However, after logistic regression, the only independent significant predictors of suicide in this age group were the presence of depressive disorders (Adjusted OR (AOR)=39.652, 95% CI 4.501-349.345), substance/alcohol abuse disorders (AOR=7.325, 95% CI 1.127-47.62), and disruptive disorders (AOR=6.464, 95% CI 1.422-29.38). Relatively small sample size, and cross-sectional design. Our findings confirm the existence of a particular clinical profile of children and adolescents at high risk for suicide. Additionally, our results reinforce the need for improved understanding of the interrelationships between stressors, depression, substance/alcohol abuse disorders, disruptive disorders and personality traits/dimensions in youth suicidal behavior.

  11. Constructive thinking skills and impulsivity dimensions in conduct and substance use disorders: differences and relationships in an adolescents' sample.

    Science.gov (United States)

    Urben, Sébastien; Suter, Maya; Pihet, Sandrine; Straccia, Claudio; Stéphan, Philippe

    2015-06-01

    Impact of conduct disorder (CD) and substance use disorder (SUD) on constructive thinking skills and impulsivity was explored. 71 offending adolescents were assessed for CD and SUD. Furthermore, the constructive thinking inventory, the immediate and delayed memory tasks and the UPPS impulsive behaviour scale were administered. Results showed that youths with CD, independently from SUD, presented higher personality impulsivity (urgency) and altered constructive thinking skills (categorical thinking and personal superstitious thinking). Furthermore, trait-impulsivity explained variation in constructive thinking skills. The implications of these results were discussed.

  12. REPETITIVE TMS ON LEFT CEREBELLUM AFFECTS IMPULSIVITY IN BORDERLINE PERSONALITY DISORDER : A PILOT STUDY

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    Giulia Zelda De Vidovich

    2016-12-01

    Full Text Available The borderline personality disorder (BPD is characterized by a severe pattern of instability in emotional regulation, interpersonal relationships, identity, and impulse control. These functions are related to the prefrontal cortex (PFC, and since PFC shows a rich anatomical connectivity with the cerebellum, the functionality of the cerebellar-PFC axis may impact on BPD. In this study we investigated the potential involvement of cerebello-thalamo-cortical connections in impulsive reactions through a pre/post stimulation design. BPD patients (n=8 and healthy controls (HC; n=9 performed an Affective Go/No-Go task (AGN assessing information processing biases for positive and negative stimuli before and after repetitive transcranial magnetic stimulation (rTMS; 1 Hz/10 min, 80% RMT over the left lateral cerebellum. The AGN task consisted of four blocks requiring associative capacities of increasing complexity. BPD patients performed significantly worse than the HC, especially when cognitive demands was high (3rd and 4th block, but their performace approached that of HC after rTMS (rTMS was almost ineffective in HC. The more evident effect of rTMS in complex associative tasks might have occurred since the cerebellum is deeply involved in integration and coordination of different stimuli. We hypothesize that, in BPD patients, cerebello-thalamo-cortical communication is altered, resulting in emotional dysregulation and disturbed impulse control. The rTMS over the left cerebellum might have interfered with existing functional connections exerting a facilitating effect on PFC control.

  13. Repetitive TMS on Left Cerebellum Affects Impulsivity in Borderline Personality Disorder: A Pilot Study.

    Science.gov (United States)

    De Vidovich, Giulia Zelda; Muffatti, Riccardo; Monaco, Jessica; Caramia, Nicoletta; Broglia, Davide; Caverzasi, Edgardo; Barale, Francesco; D'Angelo, Egidio

    2016-01-01

    The borderline personality disorder (BPD) is characterized by a severe pattern of instability in emotional regulation, interpersonal relationships, identity and impulse control. These functions are related to the prefrontal cortex (PFC), and since PFC shows a rich anatomical connectivity with the cerebellum, the functionality of the cerebellar-PFC axis may impact on BPD. In this study, we investigated the potential involvement of cerebello-thalamo-cortical connections in impulsive reactions through a pre/post stimulation design. BPD patients ( n = 8) and healthy controls (HC; n = 9) performed an Affective Go/No-Go task (AGN) assessing information processing biases for positive and negative stimuli before and after repetitive transcranial magnetic stimulation (rTMS; 1 Hz/10 min, 80% resting motor threshold (RMT) over the left lateral cerebellum. The AGN task consisted of four blocks requiring associative capacities of increasing complexity. BPD patients performed significantly worse than the HC, especially when cognitive demands were high (third and fourth block), but their performance approached that of HC after rTMS (rTMS was almost ineffective in HC). The more evident effect of rTMS in complex associative tasks might have occurred since the cerebellum is deeply involved in integration and coordination of different stimuli. We hypothesize that in BPD patients, cerebello-thalamo-cortical communication is altered, resulting in emotional dysregulation and disturbed impulse control. The rTMS over the left cerebellum might have interfered with existing functional connections exerting a facilitating effect on PFC control.

  14. Integrative Understanding of Familial Impulsivity, Early Adversity and Suicide Risk

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    Isabela M. M. Lima

    2017-12-01

    Full Text Available Introduction: Impulsivity is a core characteristic of bipolar disorder and it was observed as elevated in individuals with the disorder and in their relatives. Both impulsivity and history of maltreatment are risk factors for suicide attempts, however, these two key variables may not be independent, given the fact that parental impulsivity and associated social context could increase the risk of child maltreatment. In this study it was examined the association between the impulsivity of relatives and child maltreatment taking into consideration the conjoint and unique effects of these two variables on the risk of suicide attempts among the patients.Materials and Methods: Participants of the study consisted of 117 patients diagnosed with bipolar disorder and 25 first-degree relatives. Linear regression model was conducted to describe associations between facets of impulsivity of relatives and levels of child maltreatment reported by patients. The independent associations of suicide attempt history with the dimensions of impulsivity of the patient and maltreatment were tested by multinomial logistic regression.Results: Impulsivity of relatives and, more specifically, inhibitory control can predict the maltreatment of the patient. Inhibitory control and emotional abuse were related, conjointly, to a greater likelihood of having a history of more than one suicide attempt.Discussion: Considering that the impulsivity of relatives predicts child maltreatment, it is possible that a genetically shared impulsivity is an underlying feature associated with the history of multiple suicide attempts. These findings highlight the importance of considering child maltreatment, impulsivity and suicide attempt history in integrative models.

  15. Integrative Understanding of Familial Impulsivity, Early Adversity and Suicide Risk.

    Science.gov (United States)

    Lima, Isabela M M; Malloy-Diniz, Leandro F; de Miranda, Débora M; Da Silva, Antônio G; Neves, Fernando S; Johnson, Sheri L

    2017-01-01

    Introduction: Impulsivity is a core characteristic of bipolar disorder and it was observed as elevated in individuals with the disorder and in their relatives. Both impulsivity and history of maltreatment are risk factors for suicide attempts, however, these two key variables may not be independent, given the fact that parental impulsivity and associated social context could increase the risk of child maltreatment. In this study it was examined the association between the impulsivity of relatives and child maltreatment taking into consideration the conjoint and unique effects of these two variables on the risk of suicide attempts among the patients. Materials and Methods: Participants of the study consisted of 117 patients diagnosed with bipolar disorder and 25 first-degree relatives. Linear regression model was conducted to describe associations between facets of impulsivity of relatives and levels of child maltreatment reported by patients. The independent associations of suicide attempt history with the dimensions of impulsivity of the patient and maltreatment were tested by multinomial logistic regression. Results: Impulsivity of relatives and, more specifically, inhibitory control can predict the maltreatment of the patient. Inhibitory control and emotional abuse were related, conjointly, to a greater likelihood of having a history of more than one suicide attempt. Discussion: Considering that the impulsivity of relatives predicts child maltreatment, it is possible that a genetically shared impulsivity is an underlying feature associated with the history of multiple suicide attempts. These findings highlight the importance of considering child maltreatment, impulsivity and suicide attempt history in integrative models.

  16. Validation of the Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease (QUIP)

    Science.gov (United States)

    Weintraub, Daniel; Stewart, Staci; Shea, Judy A.; Lyons, Kelly E.; Pahwa, Rajesh; Driver-Dunckley, Erika D.; Adler, Charles H.; Potenza, Marc N.; Miyasaki, Janis; Siderowf, Andrew D.; Duda, John E.; Hurtig, Howard I.; Colcher, Amy; Horn, Stacy S.; Stern, Matthew B.; Voon, Valerie

    2010-01-01

    Objective As no comprehensive assessment instrument for impulse control disorders (ICDs) in Parkinson’s disease (PD) exists, the aim of this study was to design and assess the psychometric properties of a self-administered screening questionnaire for ICDs and other compulsive behaviors in PD. Methods The Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease (QUIP) has 3 sections: Section 1 assesses four ICDs (involving gambling, sexual, buying, and eating behaviors), Section 2 other compulsive behaviors (punding, hobbyism and walkabout), and Section 3 compulsive medication use. For validation, a convenience sample of 157 PD patients at 4 movement disorders centers first completed the QUIP, and then was administered a diagnostic interview by a trained rater blinded to the QUIP results. A shortened instrument (QUIP-S) was then explored. Results The discriminant validity of the QUIP was high for each disorder or behavior (receiver operating characteristic area under the curve [ROC AUC]: gambling=0.95, sexual behavior=0.97, buying=0.87, eating=0.88, punding=0.78, hobbyism=0.93, walkabout=0.79). On post hoc analysis, the QUIP-S ICD section had similar properties (ROC AUC: gambling=0.95, sexual behavior=0.96, buying=0.87, eating=0.88). When disorders/behaviors were combined, the sensitivity of the QUIP and QUIP-S to detect an individual with any disorder was 96% and 94%, respectively. Conclusions Scores on the QUIP appear to be valid as a self-assessment screening instrument for a range of ICDs and other compulsive behaviors that occur in PD, and a shortened version may perform as well as the full version. A positive screen should be followed by a comprehensive, clinical interview to determine the range and severity of symptoms, as well as need for clinical management. PMID:19452562

  17. State-Dependent Impulsive Control Strategies for a Tumor-Immune Model

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    Kwang Su Kim

    2016-01-01

    Full Text Available Controlling the number of tumor cells leads us to expect more efficient strategies for treatment of tumor. Towards this goal, a tumor-immune model with state-dependent impulsive treatments is established. This model may give an efficient treatment schedule to control tumor’s abnormal growth. By using the Poincaré map and analogue of Poincaré criterion, some conditions for the existence and stability of a positive order-1 periodic solution of this model are obtained. Moreover, we carry out numerical simulations to illustrate the feasibility of our main results and compare fixed-time impulsive treatment effects with state-dependent impulsive treatment effects. The results of our simulations say that, in determining optimal treatment timing, the model with state-dependent impulsive control is more efficient than that with fixed-time impulsive control.

  18. The Relationship between Impulsivity and Internet Gaming Disorder in Young Adults: Mediating Effects of Interpersonal Relationships and Depression

    Science.gov (United States)

    Ryu, Hyera; Lee, Ji-Yoon; Choi, Aruem; Park, Sunyoung; Kim, Dai-Jin

    2018-01-01

    Background: This study aimed to explore relationships between impulsivity, interpersonal relationships, depression, and Internet Gaming Disorder (IGD) symptoms. Methods: A total of 118 young adults participated in this study: 67 IGD patients who met five or more of the DSM-5 diagnostic criteria for IGD and 56 healthy controls. We administered questionnaires to assess IGD symptoms (Young’s Internet Addiction Test; Y-IAT), impulsivity (Barratt Impulsiveness Scale; BIS-11), interpersonal relationship (Relationship Change Scale; RCS), and depression (Beck Depression Inventory; BDI). We used PROCESS macro in SPSS to perform mediation analysis. Results: IGD symptom was positively related to depression and impulsivity, and negatively related to the quality of interpersonal relationships. Mediation analysis revealed full mediation effects of interpersonal relationships and depression on the association between impulsivity and IGD symptoms in the IGD group. Specifically, even after adjusting for gender as a covariate, high impulsivity was associated with greater difficulty with interpersonal relationships; which further affected depression and increased the risk of IGD. Conclusions: These results demonstrate the importance of early intervention in IGD patients, particularly in young adults with high impulsivity. When intervening in adults’ IGD, we should consider not only individual factors (e.g., depression) but also socioenvironmental factors (e.g., interpersonal relationships). PMID:29509708

  19. The Relationship between Impulsivity and Internet Gaming Disorder in Young Adults: Mediating Effects of Interpersonal Relationships and Depression.

    Science.gov (United States)

    Ryu, Hyera; Lee, Ji-Yoon; Choi, Aruem; Park, Sunyoung; Kim, Dai-Jin; Choi, Jung-Seok

    2018-03-06

    Background: This study aimed to explore relationships between impulsivity, interpersonal relationships, depression, and Internet Gaming Disorder (IGD) symptoms. Methods: A total of 118 young adults participated in this study: 67 IGD patients who met five or more of the DSM-5 diagnostic criteria for IGD and 56 healthy controls. We administered questionnaires to assess IGD symptoms (Young's Internet Addiction Test; Y-IAT), impulsivity (Barratt Impulsiveness Scale; BIS-11), interpersonal relationship (Relationship Change Scale; RCS), and depression (Beck Depression Inventory; BDI). We used PROCESS macro in SPSS to perform mediation analysis. Results: IGD symptom was positively related to depression and impulsivity, and negatively related to the quality of interpersonal relationships. Mediation analysis revealed full mediation effects of interpersonal relationships and depression on the association between impulsivity and IGD symptoms in the IGD group. Specifically, even after adjusting for gender as a covariate, high impulsivity was associated with greater difficulty with interpersonal relationships; which further affected depression and increased the risk of IGD. Conclusions: These results demonstrate the importance of early intervention in IGD patients, particularly in young adults with high impulsivity. When intervening in adults' IGD, we should consider not only individual factors (e.g., depression) but also socioenvironmental factors (e.g., interpersonal relationships).

  20. The Relationship between Impulsivity and Internet Gaming Disorder in Young Adults: Mediating Effects of Interpersonal Relationships and Depression

    Directory of Open Access Journals (Sweden)

    Hyera Ryu

    2018-03-01

    Full Text Available Background: This study aimed to explore relationships between impulsivity, interpersonal relationships, depression, and Internet Gaming Disorder (IGD symptoms. Methods: A total of 118 young adults participated in this study: 67 IGD patients who met five or more of the DSM-5 diagnostic criteria for IGD and 56 healthy controls. We administered questionnaires to assess IGD symptoms (Young’s Internet Addiction Test; Y-IAT, impulsivity (Barratt Impulsiveness Scale; BIS-11, interpersonal relationship (Relationship Change Scale; RCS, and depression (Beck Depression Inventory; BDI. We used PROCESS macro in SPSS to perform mediation analysis. Results: IGD symptom was positively related to depression and impulsivity, and negatively related to the quality of interpersonal relationships. Mediation analysis revealed full mediation effects of interpersonal relationships and depression on the association between impulsivity and IGD symptoms in the IGD group. Specifically, even after adjusting for gender as a covariate, high impulsivity was associated with greater difficulty with interpersonal relationships; which further affected depression and increased the risk of IGD. Conclusions: These results demonstrate the importance of early intervention in IGD patients, particularly in young adults with high impulsivity. When intervening in adults’ IGD, we should consider not only individual factors (e.g., depression but also socioenvironmental factors (e.g., interpersonal relationships.

  1. Impulsivity, Working Memory, and Impaired Control over Alcohol: A Latent Variable Analysis

    Science.gov (United States)

    Wardell, Jeffrey D.; Quilty, Lena C.; Hendershot, Christian S.

    2017-01-01

    Impaired control over alcohol is an important risk factor for heavy drinking among young adults and may mediate, in part, the association between personality risk and alcohol problems. Research suggests that trait impulsivity is associated with impaired control over alcohol; however, few studies of this association have included a range of impulsivity facets. The purpose of this study was to examine specific pathways from higher-order impulsivity factors to alcohol problems mediated via impaired control over alcohol. We also examined the moderating role of working memory in these associations. Young heavy drinkers (N=300) completed two multidimensional impulsivity measures (UPPS-P and BIS-11) along with self-report measures of impaired control over alcohol, alcohol use, and alcohol problems. Working memory was assessed using a computerized digit span task. Results showed that the impulsivity facets loaded onto two higher-order factors that were labeled response and reflection impulsivity. Response impulsivity predicted unique variance in self-reported impaired control and alcohol problems, whereas reflection impulsivity predicted unique variance in heavy drinking frequency only. Further, significant indirect associations were observed from response and reflection impulsivity to alcohol problems mediated via impaired control and heavy drinking frequency, respectively. Working memory and sensation seeking were not uniquely associated with the alcohol variables, and no support was found for the moderating role of working memory. The results help to clarify associations among impulsivity, impaired control, and alcohol problems, suggesting that impaired control may play a specific role in the pathway to alcohol problems from response impulsivity but not from reflection impulsivity. PMID:27269291

  2. Lisdexamfetamine Dimesylate Effects on Binge Eating Behaviour and Obsessive-Compulsive and Impulsive Features in Adults with Binge Eating Disorder.

    Science.gov (United States)

    McElroy, Susan L; Mitchell, James E; Wilfley, Denise; Gasior, Maria; Ferreira-Cornwell, M Celeste; McKay, Michael; Wang, Jiannong; Whitaker, Timothy; Hudson, James I

    2016-05-01

    In a published 11-week, placebo-controlled trial, 50 and 70 mg/d lisdexamfetamine dimesylate (LDX), but not 30 mg/d LDX, significantly reduced binge eating days (primary endpoint) in adults with binge eating disorder (BED). This report provides descriptions of LDX effects on secondary endpoints (Binge Eating Scale [BES]; Three-Factor Eating Questionnaire [TFEQ]; Yale-Brown Obsessive Compulsive Scale modified for Binge Eating [Y-BOCS-BE]; and the Barratt Impulsiveness Scale, version 11 [BIS-11]) from that study. Week 11 least squares mean treatment differences favoured all LDX doses over placebo on the BES (p ≤ 0.03), TFEQ Disinhibition and Hunger subscales (all p binge eating severity and obsessive-compulsive and impulsive features of BED in addition to binge eating days. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.

  3. The Relationship between Impulsivity and Suicide Among Rural Youths Aged 15–35 Years: A Case-Control Psychological Autopsy Study1

    Science.gov (United States)

    Lin, Lin; Zhang, Jie; Zhou, Li; Jiang, Chao

    2015-01-01

    In China, the gender ratio of suicide rates did not match the Western patterns, which was higher for females than males. However, the rural men were at relatively high risk of suicide in Liaoning province. Impulsivity was an important factor of suicide behaviors, but there was a lack of studies in China. This research aimed to study the relationship between impulsive personality traits and suicidal behavior among Chinese rural youths. Suicides were consecutively sampled from six randomly selected counties in Liaoning Province in China. Between 2005 and 2007, a total of 162 suicide victims were enrolled in the study along with 162 community controls matched for age, gender, and location. The psychological autopsy method was used to collect data from informants knowledgeable about the selected suicide victims and controls. The results showed the suicide victims in the study were more likely to demonstrate dysfunctional impulsivity and less likely to demonstrate functional impulsivity compared with the controls. Mental disorders, acute negative life events and dysfunctional impulsivity contributed to the risk of suicide; educational and functional impulsivity were protective factors. Suicide prevention efforts in rural China may address impulsivity. PMID:26110614

  4. Dopamine D3 receptor Ser9Gly variant is associated with impulse control disorders in Parkinson's disease patients.

    Science.gov (United States)

    Krishnamoorthy, Soumya; Rajan, Roopa; Banerjee, Moinak; Kumar, Hardeep; Sarma, Gangadhara; Krishnan, Syam; Sarma, Sankara; Kishore, Asha

    2016-09-01

    Impulse control disorders (ICD) are reported to occur at variable frequencies in different ethnic groups. Genetic vulnerability is suspected to underlie the individual risk for ICD. We investigated whether the allelic variants of dopamine (DRD3), glutamate (GRIN2B) and serotonin (HTR2A) receptors are linked to ICD in Indian Parkinson's disease (PD) patients. We conducted a prospective, case-control study which included PD patients (70 with ICD, 100 without ICD categorized after direct psychiatric interview of patient and caregiver) and 285 healthy controls. Single nucleotide polymorphism (SNP) variants of DRD3 p.S9G (rs6280), GRIN2B c.2664C>T (rs1806201) and HTR2A c.102T>C (rs6313) were genotyped. Multivariate regression analysis revealed that DRD3 p.Ser9Gly (rs6280) heterozygous variant CT (OR = 2.22, 95% CI: 1.03-4.86, p = 0.041), higher daily Levodopa equivalent doses (LED) of drugs (for 100 mg LED, OR = 1.14, 95% CI: 1.01-1.29, p = 0.041), current dopamine agonist but not Levodopa use (OR = 2.16, 95% CI: 1.03-4.55, p = 0.042) and age of onset of motor symptoms under 50 years (OR 2.09, 95% CI: 1.05-4.18, p = 0.035) were independently associated with ICD. DRD3 p.Ser9Gly (rs6280) CT genotype is associated with ICD in Indian PD patients and this association is novel. Enhanced D3 receptor affinity due to gain-of-function conferred by the glycine residues could impair reward-risk assessment in the mesolimbic system and contribute to development of impulsive behaviour, in carriers of this genotype. Copyright © 2016. Published by Elsevier Ltd.

  5. Trait impulsivity and impaired prefrontal impulse inhibition function in adolescents with internet gaming addiction revealed by a Go/No-Go fMRI study.

    Science.gov (United States)

    Ding, Wei-na; Sun, Jin-hua; Sun, Ya-Wen; Chen, Xue; Zhou, Yan; Zhuang, Zhi-guo; Li, Lei; Zhang, Yong; Xu, Jian-rong; Du, Ya-song

    2014-05-30

    Recent studies suggest that Internet gaming addiction (IGA) is an impulse disorder, or is at least related to impulse control disorders. In the present study, we hypothesized that different facets of trait impulsivity may be specifically linked to the brain regions with impaired impulse inhibition function in IGA adolescents. Seventeen adolescents with IGA and seventeen healthy controls were scanned during performance of a response-inhibition Go/No-Go task using a 3.0 T MRI scanner. The Barratt Impulsiveness Scale (BIS)-11 was used to assess impulsivity. There were no differences in the behavioral performance on the Go/No-Go task between the groups. However, the IGA group was significantly hyperactive during No-Go trials in the left superior medial frontal gyrus, right anterior cingulate cortex, right superior/middle frontal gyrus, left inferior parietal lobule, left precentral gyrus, and left precuneus and cuneus. Further, the bilateral middle temporal gyrus, bilateral inferior temporal gyrus, and right superior parietal lobule were significantly hypoactive during No-Go trials. Activation of the left superior medial frontal gyrus was positively associated with BIS-11 and Chen Internet Addiction Scale (CIAS) total score across IGA participants. Our data suggest that the prefrontal cortex may be involved in the circuit modulating impulsivity, while its impaired function may relate to high impulsivity in adolescents with IGA, which may contribute directly to the Internet addiction process.

  6. Application of Impulse Control in Smart Grid Price System

    Directory of Open Access Journals (Sweden)

    Peng Du

    2013-07-01

    Full Text Available With the development of smart grid, flexible and interactive electricity market will finally emerge. Making full use of price can encourage consumers to use electricity during a low load period and reduce peak load, thus to guarantee electricity market stability. Impulse control is applied to price system in this paper. It is found that giving impulse control to price system can make the system reach stable state well, which is based on the theory of impulsive differential system. The sufficient condition for stable system and the max upper bound of impulse interval are also provided. The proposed method is proved to be feasible and effective by theoretically analysis and numerical simulation.

  7. Orbitofrontal reward sensitivity and impulsivity in adult attention deficit hyperactivity disorder.

    Science.gov (United States)

    Wilbertz, Gregor; van Elst, Ludger Tebartz; Delgado, Mauricio R; Maier, Simon; Feige, Bernd; Philipsen, Alexandra; Blechert, Jens

    2012-03-01

    Impulsivity symptoms of adult attention deficit hyperactivity disorder (ADHD) such as increased risk taking have been linked with impaired reward processing. Previous studies have focused on reward anticipation or on rewarded executive functioning tasks and have described a striatal hyporesponsiveness and orbitofrontal alterations in adult and adolescent ADHD. Passive reward delivery and its link to behavioral impulsivity are less well understood. To study this crucial aspect of reward processing we used functional magnetic resonance imaging (fMRI) combined with electrodermal assessment in male and female adult ADHD patients (N=28) and matched healthy control participants (N=28) during delivery of monetary and non-monetary rewards. Further, two behavioral tasks assessed risky decision making (game of dice task) and delay discounting. Results indicated that both groups activated ventral and dorsal striatum and the medial orbitofrontal cortex (mOFC) in response to high-incentive (i.e. monetary) rewards. A similar, albeit less strong activation pattern was found for low-incentive (i.e. non-monetary) rewards. Group differences emerged when comparing high and low incentive rewards directly: activation in the mOFC coded for the motivational change in reward delivery in healthy controls, but not ADHD patients. Additionally, this dysfunctional mOFC activity in patients correlated with risky decision making and delay discounting and was paralleled by physiological arousal. Together, these results suggest that the mOFC codes reward value and type in healthy individuals whereas this function is deficient in ADHD. The brain-behavior correlations suggest that this deficit might be related to behavioral impulsivity. Reward value processing difficulties in ADHD should be considered when assessing reward anticipation and emotional learning in research and applied settings. Copyright © 2011 Elsevier Inc. All rights reserved.

  8. Impulsivity and Gambling Type Among Treatment-Seeking Disordered Gamblers: An Explorative Study.

    Science.gov (United States)

    Lutri, Vittorio; Soldini, Emiliano; Ronzitti, Silvia; Smith, Neil; Clerici, Massimo; Blaszczynski, Alex; Bowden-Jones, Henrietta

    2018-03-03

    Several studies have found that certain traits of impulsivity are associated with gambling disorder, and influence its severity. Furthermore, it has been suggested that some forms of gambling, particularly electronic gambling machines, are particularly widespread among pathological gamblers. In the present, exploratory study, we aim to clarify the role played by impulsivity in influencing the choice of specific gambling activities, by examining the relation between individual dimensions of impulsivity, and the choice of specific gambling activities in a clinical population. 100 consecutively admitted pathological gamblers at the National Problem Gambling Clinic in London (UK) in 2014 were administered the UPPS-P and BIS-11 impulsivity questionnaires, the Problem Gambling Severity Index, and underwent a structured interview concerning their gambling activities in the month and year prior to assessment. The correlation between individual gambling activities and impulsivity dimensions was analyzed both at a bivariate level, and using logistic regression. We found a significant correlation between Negative Urgency, Motor impulsivity and low-stakes machine gambling on multivariate analysis. Negative urgency (i.e. the tendency to act impulsively in response to negative affect), and Motor impulsivity (a tendency to rash action and restlessness) might be mediating factors in the choice of electronic gambling machines, particularly among patients whose gambling is escape-oriented. Structural and situational characteristics of gambling machines, particularly the widespread availability of low-stakes-rather than high-stakes-gaming machines, might concur to the choice of this form of gambling among individuals who present higher negative urgency and restlessness.

  9. The Role of Different Aspects of Impulsivity as Independent Risk Factors for Substance Use Disorders in Patients with ADHD: A Review

    NARCIS (Netherlands)

    Ortal, Slobodin; van de Glind, Geurt; Johan, Franck; Itai, Berger; Nir, Yachin; Iliyan, Ivanov; van den Brink, Wim

    2015-01-01

    High impulsivity in children with attention deficit/hyperactivity disorder (ADHD) plays a key role in their vulnerability to substance abuse disorders (SUDs). Although impulsivity is increasingly recognized as a multidimensional construct, efforts to describe the contribution of different

  10. The impulsive control synchronization of the drive-response complex system

    International Nuclear Information System (INIS)

    Zhao Yanhong; Yang Yongqing

    2008-01-01

    This Letter investigates projective synchronization between the drive system and response complex dynamical system. An impulsive control scheme is adapted to synchronize the drive-response dynamical system to a desired scalar factor. By using the stability theory of the impulsive differential equation, the criteria for the projective synchronization are derived. The feasibility of the impulsive control of the projective synchronization is demonstrated in the drive-response dynamical system

  11. A randomized, controlled, crossover trial of fish oil treatment for impulsive aggression in children and adolescents with disruptive behavior disorders.

    Science.gov (United States)

    Dean, Angela J; Bor, William; Adam, Kareen; Bowling, Francis G; Bellgrove, Mark A

    2014-04-01

    Epidemiological research links aggression to low serum concentrations of omega-3 fatty acids, such as those found in fish oil. However, no studies have specifically examined whether fish oil supplementation can reduce the frequency and severity of impulsive aggression in children with disruptive behavior disorders. Children presenting with impulsive aggression and meeting research criteria for diagnosis of disruptive behavior disorders were randomized to receive either: 1) Fish oil capsules (4 g daily) for 6 weeks followed by placebo (identical-looking capsules) for 6 weeks; or 2) placebo for 6 weeks, followed by fish oil for 6 weeks, in a double-blind, crossover design. Primary outcomes were the Children's Aggression Scale and the Modified Overt Aggression Scale. Secondary outcomes included emotional and behavioral functioning (Strengths and Difficulties Questionnaire [SDQ]), hyperactivity symptoms (Attention-Deficit/Hyperactivity Disorder [ADHD] Rating Scale), family functioning (Family Assessment Device), and cognitive functioning (Stop Signal Task, Trail-Making Task, and Eriksen Flanker Task). Serum concentrations of omega-3 and omega-6 fatty acids were measured at baseline, and at 6 and 12 weeks. Twenty-one children participated (81% male; mean age 10.3±2.2 years; range 7-14). Fish oil treatment increased serum concentrations of eicosapentanoic acid (F=14.76, pConduct Subscale, F=4.34, p=0.06). Fish oil treatment was associated with an improvement in one rating of hyperactivity (SDQ Hyperactivity Subscale, F=2.22, pchildren with disruptive behavior disorders.

  12. The high prevalence of impulse control behaviors in patients with early-onset Parkinson's disease: A cross-sectional multicenter study.

    Science.gov (United States)

    Vela, L; Martínez Castrillo, J C; García Ruiz, P; Gasca-Salas, C; Macías Macías, Y; Pérez Fernández, E; Ybot, I; Lopez Valdés, E; Kurtis, M M; Posada Rodriguez, I J; Mata, M; Ruiz Huete, C; Eimil, M; Borrue, C; Del Val, J; López-Manzanares, L; Rojo Sebastian, A; Marasescu, R

    2016-09-15

    In Parkinson's disease patients, impulse control disorders (ICDs) have been associated with younger age and early disease onset, yet the prevalence of ICDs in early-onset Parkinson's disease (EOPD) patients has yet to be studied. Thus, we set out to compare the prevalence of impulse control behaviors (ICBs) in a cohort of EOPD patients with that in age and gender matched healthy controls (HCs), as well as to analyze the association of these symptoms with the use of dopaminergic drugs and other clinical or demographic factors. A cross-sectional, multicenter study was carried out on patients recruited from outpatient Movement Disorder Clinics, assessing ICBs using the short form of the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease (QUIP). In addition, depression and quality of life (QoL) were measured, along with other demographic and clinical variables. Of the 87 EOPD patients, 49 (58.3%) displayed an ICB, as did 28 of the 87 HCs (32.9%; p=0.001). Most of the EOPD patients that displayed an ICB (91.8%) were medicated with a dopamine agonist (DA) and accordingly, DA treatment was associated with a 7-fold increased risk of developing an ICB. Patients with ICBs had a higher depression score and a worse QoL. ICBs are much more prevalent in EOPD patients than in HCs and they are associated with DA intake, depression and a worse QoL. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. Impulsive behavior and nicotinic acetylcholine receptors.

    Science.gov (United States)

    Ohmura, Yu; Tsutsui-Kimura, Iku; Yoshioka, Mitsuhiro

    2012-01-01

    Higher impulsivity is thought to be a risk factor for drug addiction, criminal involvement, and suicide. Excessive levels of impulsivity are often observed in several psychiatric disorders including attention-deficit/hyperactivity disorder and schizophrenia. Previous studies have demonstrated that nicotinic acetylcholine receptors (nAChRs) are involved in impulsive behavior. Here, we introduce recent advances in this field and describe the role of the following nAChR-related brain mechanisms in modulating impulsive behavior: dopamine release in the ventral striatum; α4β2 nAChRs in the infralimbic cortex, which is a ventral part of the medial prefrontal cortex (mPFC); and dopamine release in the mPFC. We also suggest several potential therapeutic drugs to address these mechanisms in impulsivity-related disorders and explore future directions to further elucidate the roles of central nAChRs in impulsive behavior.

  14. Infinite horizon optimal impulsive control with applications to Internet congestion control

    Science.gov (United States)

    Avrachenkov, Konstantin; Habachi, Oussama; Piunovskiy, Alexey; Zhang, Yi

    2015-04-01

    We investigate infinite-horizon deterministic optimal control problems with both gradual and impulsive controls, where any finitely many impulses are allowed simultaneously. Both discounted and long-run time-average criteria are considered. We establish very general and at the same time natural conditions, under which the dynamic programming approach results in an optimal feedback policy. The established theoretical results are applied to the Internet congestion control, and by solving analytically and nontrivially the underlying optimal control problems, we obtain a simple threshold-based active queue management scheme, which takes into account the main parameters of the transmission control protocols, and improves the fairness among the connections in a given network.

  15. Tumour chemotherapy strategy based on impulse control theory.

    Science.gov (United States)

    Ren, Hai-Peng; Yang, Yan; Baptista, Murilo S; Grebogi, Celso

    2017-03-06

    Chemotherapy is a widely accepted method for tumour treatment. A medical doctor usually treats patients periodically with an amount of drug according to empirical medicine guides. From the point of view of cybernetics, this procedure is an impulse control system, where the amount and frequency of drug used can be determined analytically using the impulse control theory. In this paper, the stability of a chemotherapy treatment of a tumour is analysed applying the impulse control theory. The globally stable condition for prescription of a periodic oscillatory chemotherapeutic agent is derived. The permanence of the solution of the treatment process is verified using the Lyapunov function and the comparison theorem. Finally, we provide the values for the strength and the time interval that the chemotherapeutic agent needs to be applied such that the proposed impulse chemotherapy can eliminate the tumour cells and preserve the immune cells. The results given in the paper provide an analytical formula to guide medical doctors to choose the theoretical minimum amount of drug to treat the cancer and prevent harming the patients because of over-treating.This article is part of the themed issue 'Horizons of cybernetical physics'. © 2017 The Author(s).

  16. The role of impulsivity, inattention and comorbid ADHD in patients with bulimia nervosa.

    Directory of Open Access Journals (Sweden)

    Jochen Seitz

    Full Text Available INTRODUCTION: Little is known about the contribution of impulsivity, inattention and comorbid attention deficit/hyperactivity disorder (ADHD in the development and maintenance of bulimia nervosa (BN. In particular, their specific contribution to disordered eating symptoms and whether they have additive effects to the general psychopathological burden remains unclear. METHODS: Fifty-seven female patients seeking treatment for BN and 40 healthy controls completed diagnostic questionnaires and interviews that investigated: a ADHD, b impulsivity, c eating disorders and d general psychopathology. Attentional processes and impulsivity were assessed by a comprehensive computer-based neuropsychological battery. RESULTS: Twenty-one percent of patients with BN met the clinical cut-off for previous childhood ADHD compared to 2.5% of healthy controls. Adult ADHD according to DSM IV was also more prevalent in patients with BN, with an odds ratio of 4.2. Patients with BN and previous childhood ADHD were more impulsive and inattentive than patients with BN alone. These patients also displayed more severely disordered eating patterns and more general psychopathological symptoms compared with those without ADHD. Severity of eating disorder symptoms was better explained by inattentiveness than by either impulsivity or hyperactivity. DISCUSSION: Our data suggest an elevated rate of former childhood and current ADHD-symptoms in treatment-seeking patients with BN. Stronger impulsivity and inattention associated with more severe neuropsychological deficits and eating disorder symptoms indicate an additive risk that is clinically relevant for these patients. Thus, clinicians should identify comorbid patients who might profit from additional ADHD-specific treatments.

  17. IMPULSIVE-COMPULSIVE DISORDERS IN PARKINSON'S DISEASE. CLINICAL CASES

    OpenAIRE

    N. V. Fedorova; A. V. Nikitina

    2015-01-01

    Objective – a description of clinical cases of impulsive­compulsive disorders in Parkinson,s disease. The first clinical case. Patient N., 75 years old, suffering for 15 years from Parkinson,s disease, akinetic­rigid form of the disease, stage 4 by Hyun–Yar. Since 2009, he received levodopa/carbidopa 250/25 mg 5 times/day (daily dose of 1250 mg of levodopa); pramipexole 3.5 mg per day (daily dose 3.5 mg), amantadine sulfate 100 mg 5 times/day (daily dose 500 mg). While taking antiparkinsonian...

  18. The Impact of Dialectic Behavior Therapy on the Reduction of Impulsiveness in Women with Comorbidity of Borderline Personality Disorder and Substance Abuse

    Directory of Open Access Journals (Sweden)

    Alireza Aghayousefi

    2015-09-01

    Full Text Available Objective: This study aimed to examine the effect of dialectic behavior therapy on the reduction of impulsiveness in women with comorbidity of borderline personality disorders and substance abuse. Method: An experimental single system research design using multiple baselines was employed for this study. Based on the structured diagnostic interview and entry criteria, four participants among female patients with borderline personality disorders and substance abuse were selected via purposive sampling method. All four subjects received twelve dialectic behavior therapy sessions. Then, Impulsiveness Bart Scale (IBS was used to measure impulsiveness. Results: Dialectic behavior therapy led to the significant reduction of impulsiveness scores in women with borderline personality disorders and substance abuse. Graphs pertaining to the effectiveness and effect size indicate a significant decrease in participants’ impulsiveness. Conclusion: Dialectic behavior therapy interventions can contribute to the decrease of impulsiveness and bring about desired practical implications in the treatment and prevention of substance abuse.

  19. Effect of Developmental Quotient on Symptoms of Inattention and Impulsivity among Toddlers with Autism Spectrum Disorders

    Science.gov (United States)

    Matson, Johnny L.; Mahan, Sara; Hess, Julie A.; Fodstad, Jill C.

    2010-01-01

    The effect of developmental quotient on symptoms of inattention and impulsivity was examined among 198 toddlers with Autism Spectrum Disorders. There were two levels of developmental quotient: (1) low (less than or equal to 70; n = 80), and (2) typical (greater than 70; n = 118). Symptoms of inattention and impulsivity were assessed using 14 items…

  20. Impulsivity in Parkinson’s Disease Is Associated With Alterations in Affective and Sensorimotor Striatal Networks

    Directory of Open Access Journals (Sweden)

    Marit F. L. Ruitenberg

    2018-04-01

    Full Text Available A subset of patients with Parkinson’s disease (PD experiences problems with impulse control, characterized by a loss of voluntary control over impulses, drives, or temptations regarding excessive hedonic behavior. The present study aimed to better understand the neural basis of such impulse control disorders (ICDs in PD. We collected resting-state functional connectivity and structural MRI data from 21 PD patients with ICDs and 30 patients without such disorders. To assess impulsivity, all patients completed the Barratt Impulsiveness Scale and performed an information-gathering task. MRI results demonstrated substantial differences in neural characteristics between PD patients with and without ICDs. Results showed that impulsivity was linked to alterations in affective basal ganglia circuitries. Specifically, reduced frontal–striatal connectivity and GPe volume were associated with more impulsivity. We suggest that these changes affect decision making and result in a preference for risky or inappropriate actions. Results further showed that impulsivity was linked to alterations in sensorimotor striatal networks. Enhanced connectivity within this network and larger putamen volume were associated with more impulsivity. We propose that these changes affect sensorimotor processing such that patients have a greater propensity to act. Our findings suggest that the two mechanisms jointly contribute to impulsive behaviors in PD.

  1. The comparition of Personality Patterns, irrational beliefs and impulsivity in males with with drug abuse disorder under Treatment

    Directory of Open Access Journals (Sweden)

    samere asadi

    2015-03-01

    Full Text Available Objective: the aim of this research was to determine the difference between personality Patterns, irrational beliefs and impulsivity in men with drug abuse disorder under Treatment. Method: in this casual- comparative research, 80 men ( 40 males with drug abuse under Treatment and 40 of normal males that were selected with available sampling .Groups were matched in terms of demoghraphy characteristics ( age, sexuality, education level and marital status and were valued with means of Eysenk Perceived Stress Inventory, Jonze Irrational Beliefs Scale and Baret Impulsivity Inventory. Results: The result of variance analysis showed that addicts compared to normal people, get more scores on extraversion, neuroticism and psychosis. Addicts group had Higher men scores in irrational beliefs compare of other group. There was significant difference between groups in impulsivity and impulsivity in addicts persons is the most. Conclussion: The traits of Personality, irrational beliefs and Unrealistic and high level impulsivity are factors that propel individuals toward more drug abuse and finally addict and aiming this factors in individuals with abuse disorder under Treatment can lead to prevent of Substance Abuse Relapse.

  2. Impulsive and compulsive behaviors among Danish patients with Parkinson's disease: prevalence, depression, and personality.

    Science.gov (United States)

    Callesen, M B; Weintraub, D; Damholdt, M F; Møller, A

    2014-01-01

    Dopaminergic medication administered to ameliorate motor symptoms of Parkinson's disease is associated with impulse control disorders, such as pathological gambling, hypersexuality, compulsive buying, and binge eating. Studies indicate a prevalence of impulse control disorders in Parkinson's disease of 6-16%. To estimate the prevalence of impulsive and compulsive behaviors among Danish patients with Parkinson's disease and to explore the relation of such behavioral disorders to depression and personality. 490 patients with Parkinson's disease (303 males), identified through the National Danish Patient Registry, were evaluated with: 1) the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease; 2) the Geriatric Depression Scale; and 3) the NEO-Personality Inventory. 176 (35.9%) patients reported impulsive and compulsive behaviors sometime during Parkinson's disease (current symptoms in 73, 14.9%). Hereof, 114 (23.3%) reported multiple behavioral symptoms. Patients with behavioral symptoms were significantly younger, were younger at PD onset, had longer disease duration, displayed more motor symptoms, and received higher doses of dopaminergic medication than patients without behavioral symptoms. Furthermore, they reported significantly more depressive symptoms and scored significantly higher on neuroticism and lower on both agreeableness and conscientiousness than patients without behavioral symptoms. A history of impulsive and compulsive behaviors are common in Danish patients with Parkinson's disease and have clinical correlates that may allow identification of patients at risk for developing these behaviors. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. The Role of Different Aspects of Impulsivity as Independent Risk Factors for Substance Use Disorders in Patients with ADHD: A Review.

    Science.gov (United States)

    Ortal, Slobodin; van de Glind, Geurt; Johan, Franck; Itai, Berger; Nir, Yachin; Iliyan, Ivanov; van den Brink, Wim

    2015-01-01

    High impulsivity in children with attention deficit/hyperactivity disorder (ADHD) plays a key role in their vulnerability to substance abuse disorders (SUDs). Although impulsivity is increasingly recognized as a multidimensional construct, efforts to describe the contribution of different impulsivity aspects to the development of SUD have been hindered by conceptual and experimental inconsistencies. This review seeks to map potential trajectories from childhood ADHD to SUD by examining the hypothesized mediating role of three different impulsivity-related constructs: disinhibition, impulsive choice, and sensation seeking. Integration of data from developmental, cognitive, and neurophysiological research suggests that childhood ADHD and SUD are both associated with behavioural and neurophysiological deficits in all three impulsivity-related constructs. Examination of brain mechanisms related to the three impulsivity-related constructs indicates that ADHD share neurophysiological deficits with SUD, such as abnormal brain activity in areas involved in inhibition and complex cognitive-emotional processes. We conclude that different impulsivity constructs operate independently and interact with each other to affect adult risk taking behaviour and SUD in patients with childhood ADHD. This review highlights the current theoretical and methodological challenges in the study of impulsivity and discusses clinical implications and directions for future research.

  4. Pinning impulsive control algorithms for complex network

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Wen [School of Information and Mathematics, Yangtze University, Jingzhou 434023 (China); Lü, Jinhu [Academy of Mathematics and Systems Science, Chinese Academy of Sciences, Beijing 100190 (China); Chen, Shihua [College of Mathematics and Statistics, Wuhan University, Wuhan 430072 (China); Yu, Xinghuo [School of Electrical and Computer Engineering, RMIT University, Melbourne VIC 3001 (Australia)

    2014-03-15

    In this paper, we further investigate the synchronization of complex dynamical network via pinning control in which a selection of nodes are controlled at discrete times. Different from most existing work, the pinning control algorithms utilize only the impulsive signals at discrete time instants, which may greatly improve the communication channel efficiency and reduce control cost. Two classes of algorithms are designed, one for strongly connected complex network and another for non-strongly connected complex network. It is suggested that in the strongly connected network with suitable coupling strength, a single controller at any one of the network's nodes can always pin the network to its homogeneous solution. In the non-strongly connected case, the location and minimum number of nodes needed to pin the network are determined by the Frobenius normal form of the coupling matrix. In addition, the coupling matrix is not necessarily symmetric or irreducible. Illustrative examples are then given to validate the proposed pinning impulsive control algorithms.

  5. Pinning impulsive control algorithms for complex network

    International Nuclear Information System (INIS)

    Sun, Wen; Lü, Jinhu; Chen, Shihua; Yu, Xinghuo

    2014-01-01

    In this paper, we further investigate the synchronization of complex dynamical network via pinning control in which a selection of nodes are controlled at discrete times. Different from most existing work, the pinning control algorithms utilize only the impulsive signals at discrete time instants, which may greatly improve the communication channel efficiency and reduce control cost. Two classes of algorithms are designed, one for strongly connected complex network and another for non-strongly connected complex network. It is suggested that in the strongly connected network with suitable coupling strength, a single controller at any one of the network's nodes can always pin the network to its homogeneous solution. In the non-strongly connected case, the location and minimum number of nodes needed to pin the network are determined by the Frobenius normal form of the coupling matrix. In addition, the coupling matrix is not necessarily symmetric or irreducible. Illustrative examples are then given to validate the proposed pinning impulsive control algorithms

  6. Asymptotic stability of a genetic network under impulsive control

    International Nuclear Information System (INIS)

    Li Fangfei; Sun Jitao

    2010-01-01

    The study of the stability of genetic network is an important motif for the understanding of the living organism at both molecular and cellular levels. In this Letter, we provide a theoretical method for analyzing the asymptotic stability of a genetic network under impulsive control. And the sufficient conditions of its asymptotic stability under impulsive control are obtained. Finally, an example is given to illustrate the effectiveness of the obtained method.

  7. The clinical assessment of impulsivity

    Directory of Open Access Journals (Sweden)

    Nagesh Brahmavar Pai

    2018-01-01

    Full Text Available The term impulsivity is often used to describe behavior that is both spontaneous and detrimental. Impulsivity is multidimensional and derives from personality, general psychopathology as well as specific mental disorders. Thus, the construct of impulsivity is important as it is associated with numerous mental disorders as well as socially deviant behaviors ranging from behaviors targeted towards others such as aggression, to behaviors targeted toward oneself, for example, self-harm and suicide. As a clinical construct impulsivity is highly predictive of poor prognosis thus further emphasizing its clinical relevance. Therefore, the need exists for impulsivity to be clinically assessed and this assessment should take place at the same time as the assessment of risk. As risk and impulsivity are interrelated and interact. Although there are existing self-report rating scales for trait-based impulsivity, a dearth exists in regards to assessment of impulsivity in clinical practice that is focused and pragmatic. Thus, a pragmatic rubric to guide the individualized assessment of impulsivity in a clinical population is proposed. The quadrants espoused will assist both with the formulation of questions and categorization of responses to determine the most appropriate interventions for the client.

  8. Evaluation of the utility of Liebowitz Social Anxiety Scale and Barratt Impulsiveness Scale in the diagnosis of social anxiety, impulsivity and depression.

    Science.gov (United States)

    Tyrała, Kinga; Seweryn, Mariusz; Bonk, Magdalena; Bulska, Weronika; Orszulak, Kamila; Bratek, Agnieszka; Krysta, Krzysztof

    2015-09-01

    Often mental disorders are serious problems concerning psychological well-being. They require comprehensive and specialized psychiatric and psychological help, but there are no public methods of controlling your mental state. The aim of study was the evaluation of the utility of Liebowitz Social Anxiety Scale and Barratt Impulsiveness Scale in the diagnosis of social anxiety, impulsivity and depression. The study included 85 persons. The study group had 34 patients treated in an open ward of the Department of Psychiatry and Psychotherapy of Medical University of Silesia in Katowice. The control group included 51 persons without mental disorders. Three self-rating questionnaires were used: Beck Depression Inventory, Barratt Impulsiveness Scale and Liebowitz Social Anxiety Scale. Statistica v10 Statsoft software was used for statistical analysis. The analyzed groups had significant differences in terms of Beck Scale (U Mann-Whitney test p=0.000001). Average score in study group: 22.94±12.50; in control group: 7.15±6.44. Groups had significant differences in terms of Liebowitz Scale (U test Mann-Whitney test, p=0.000164). Average score in the study group: 60.41±30.30; in control group: 35.01±23.94. Groups had significant differences in terms of Barratt Scale (t-student test p=0.000601). Average in study group: 66.35±9,49; in control group: 59.54±7.87. Significant positive correlation was observed between the results of Beck Scale and Liebowitz Scale (r=0.64465). Correlation was not observed between the results of the Liebowitz and Barrat (r=0.12091 and Beck and Barrat (r=0.21482). The intensity of the Liebowitz Social Anxiety Scale is directly proportional to the severity of depression according to the Beck Depression Inventory. The degree of impulsivity by Barrat Impulsiveness Scale does not correlate with the level of depression according to Beck Depression Inventory. The analyzed scales are relevant in the diagnosis of mental disorders.

  9. Choice-impulsivity in children and adolescents with attention-deficit/hyperactivity disorder (ADHD): A meta-analytic review.

    Science.gov (United States)

    Patros, Connor H G; Alderson, R Matt; Kasper, Lisa J; Tarle, Stephanie J; Lea, Sarah E; Hudec, Kristen L

    2016-02-01

    Impulsive behavior is a core DSM-5 diagnostic feature of attention-deficit/hyperactivity disorder (ADHD) that is associated with several pejorative outcomes. Impulsivity is multidimensional, consisting of two sub-constructs: rapid-response impulsivity and reward-delay impulsivity (i.e., choice-impulsivity). While previous research has extensively examined the presence and implications of rapid-response impulsivity in children with ADHD, reviews of choice-impulsive behavior have been both sparse and relatively circumscribed. This review used meta-analytic methods to comprehensively examine between-group differences in choice-impulsivity among children and adolescents with and without ADHD. Twenty-eight tasks (from 26 studies), consisting of 4320 total children (ADHD=2360, TD=1,960), provided sufficient information to compute an overall between-group effect size for choice-impulsivity performance. Results revealed a medium-magnitude between-group effect size (g=.47), suggesting that children and adolescents with ADHD exhibited moderately increased impulsive decision-making compared to TD children and adolescents. Further, relative to the TD group, children and adolescents with ADHD exhibited similar patterns of impulsive decision-making across delay discounting and delay of gratification tasks. However, the use of single-informant diagnostic procedures relative to multiple informants yielded larger between-group effects, and a similar pattern was observed across samples that excluded females relative to samples that included females. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Fuzzy Impulsive Control of Permanent Magnet Synchronous Motors

    International Nuclear Information System (INIS)

    Dong, Li; Shi-Long, Wang; Xiao-Hong, Zhang; Dan, Yang; Hui, Wang

    2008-01-01

    The permanent magnet synchronous motors (PMSMs) may experience chaotic behaviours with systemic parameters falling into a certain area or under certain working conditions, which threaten the secure and stable operation of motor-driven. Hence, it is important to study the methods of controlling or suppressing chaos in PMSMs. In this work, the Takagi–Sugeno (T-S) fuzzy impulsive control model for PMSMs is established via the T-S modelling methodology and impulsive technology. Based on the new model, the control conditions of asymptotical stability and exponential stability for PMSMs have been derived by the Lyapunov method. Finally, an illustrated example is also given to show the effectiveness of the obtained results

  11. Impulsivity, aggression and brain structure in high and low lethality suicide attempters with borderline personality disorder.

    Science.gov (United States)

    Soloff, Paul; White, Richard; Diwadkar, Vaibhav A

    2014-06-30

    Impulsivity and aggressiveness are trait dispositions associated with the vulnerability to suicidal behavior across diagnoses. They are associated with structural and functional abnormalities in brain networks involved in regulation of mood, impulse and behavior. They are also core characteristics of borderline personality disorder (BPD), a disorder defined, in part, by recurrent suicidal behavior. We assessed the relationships between personality traits, brain structure and lethality of suicide attempts in 51 BPD attempters using multiple regression analyses on structural MRI data. BPD was diagnosed by the Diagnostic Interview for Borderline Patients-revised, impulsivity by the Barratt Impulsiveness Scale (BIS), aggression by the Brown-Goodwin Lifetime History of Aggression (LHA), and high lethality by a score of 4 or more on the Lethality Rating Scale (LRS). Sixteen High Lethality attempters were compared to 35 Low Lethality attempters, with no significant differences noted in gender, co-morbidity, childhood abuse, BIS or LHA scores. Degree of medical lethality (LRS) was negatively related to gray matter volumes across multiple fronto-temporal-limbic regions. Effects of impulsivity and aggression on gray matter volumes discriminated High from Low Lethality attempters and differed markedly within lethality groups. Lethality of suicide attempts in BPD may be related to the mediation of these personality traits by specific neural networks. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  12. Eating disorders and food addiction in men with heroin use disorder: a controlled study.

    Science.gov (United States)

    Canan, Fatih; Karaca, Servet; Sogucak, Suna; Gecici, Omer; Kuloglu, Murat

    2017-06-01

    We aimed to determine the prevalence estimates of binge eating disorder, bulimia nervosa, anorexia nervosa, and food addiction in men with heroin use disorder and a matched sample of control participants. A group of 100 men with heroin use disorder, consecutively admitted to a detoxification and therapy unit, were screened for DSM-5 eating disorders, along with a group of 100 male controls of similar age, education, and body mass index. The Yale Food Addiction Scale (YFAS), the Barratt Impulsivity Scale-version 11, and the Eating Attitudes Test were used for data collection. Patients were also evaluated for various aspects of heroin use disorder (e.g., craving) using the Addiction Profile Index. Binge eating disorder that met DSM-5 criteria was more prevalent in patients with heroin use disorder (21%) than in control subjects (8%) (odds ratio 3.1, 95% confidence interval 1.3-7.3; p disorder (28%) than among control participants (12%) (odds ratio 2.9, 95% confidence interval 1.4-6.1; p eating disorder and food addiction are highly frequent in men with heroin use disorder. Screening for binge eating disorder and food addiction in patients with substance use disorder is important, as interventions may improve treatment outcome in this patient group.

  13. Acute effects of methylphenidate on impulsivity and attentional behavior among adolescents comorbid for ADHD and conduct disorder.

    Science.gov (United States)

    Dougherty, Donald M; Olvera, Rene L; Acheson, Ashley; Hill-Kapturczak, Nathalie; Ryan, Stacy R; Mathias, Charles W

    2016-12-01

    Adolescents with Attention Deficit Hyperactivity Disorder (ADHD) and Conduct Disorder (CD) experience deficits in neuropsychological measures of attention, inhibition, and reward processes. Methylphenidate treatment for ADHD and CD has acute effects on these processes. Some of these same aspects of performance are separately described in the Behavioral Model of Impulsivity, which uses a modified approach to measurement. This study characterized the acute effects of methylphenidate attention, initiation, inhibition, and reward processes described in this model of impulsivity. Thirty-one adolescents from the United States of America with comorbid ADHD and CD completed measures of impulsivity (response initiation, response inhibition, and consequence) and attention following placebo, 20 mg, and 40 mg of a long-acting dose of methylphenidate. Methylphenidate effects on attentional performance was more robust than on any of the measures of impulsivity. Adolescent performance from this behavioral perspective is interpreted in the context of divergence from previous neuropsychological tests of acute methylphenidate effects. Copyright © 2016 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  14. Impulsivity and compulsive buying are associated in a non-clinical sample: an evidence for the compulsivity-impulsivity continuum?

    Science.gov (United States)

    Paula, Jonas J de; Costa, Danielle de S; Oliveira, Flavianne; Alves, Joana O; Passos, Lídia R; Malloy-Diniz, Leandro F

    2015-01-01

    Compulsive buying is controversial in clinical psychiatry. Although it is defined as an obsessive-compulsive disorder, other personality aspects besides compulsivity are related to compulsive buying. Recent studies suggest that compulsivity and impulsivity might represent a continuum, with several psychiatric disorders lying between these two extremes. In this sense, and following the perspective of dimensional psychiatry, symptoms of impulsivity and compulsivity should correlate even in a non-clinical sample. The present study aims to investigate whether these two traits are associated in a healthy adult sample. We evaluated 100 adults, with no self-reported psychiatric disorders, using the Barratt Impulsiveness Scale-11 and two scales of compulsive buying. Using multiple linear regressions, we found that impulsivity accounted for about 15% of variance in the compulsive-buying measure. Our results suggest that an association between impulsivity and compulsive buying occurs even in non-clinical samples, evidence that compulsivity and impulsivity might form a continuum and that compulsive buying might be an intermediate condition between these two personality traits.

  15. Impulse control disorder and response-inhibition alterations in Parkinson's disease. A rare case of totally absent functionality of the medial-prefrontal cortex and review of literature.

    Science.gov (United States)

    Palermo, Sara; Morese, Rosalba; Zibetti, Maurizio; Dematteis, Francesca; Sirgiovanni, Stefano; Stanziano, Mario; Valentini, Maria Consuelo; Lopiano, Leonardo

    2017-11-01

    This report illustrates a Parkinson's disease (PD) patient with impulse-control disorder (ICD) and selective impairment in response-inhibition abilities as revealed by the performance in a functional magnetic resonance imaging (fMRI) anterior cingulate cortex - sensitive go-nogo task. In line with hypothesis on the role of response-inhibition disabilities in the arising of impulsivity in PD, the patient completely failed the go-nogo task. Moreover, fMRI acquisition revealed absent task-sensitive activity in the anterior cingulate cortex, medial prefrontal, and orbitofrontal cortices for the contrast nogo versus go, which signifying that a hypo-function of this network could be associated with ICD. A fronto-striatal and cingulo-frontal dysfunction may reflect impairment in metacognitive-executive abilities (such as response-inhibition, action monitoring, and error awareness) and promote compulsive repetition of behavior. Response-inhibition tasks may be useful in PD post-diagnostic phase, to better identify individuals at risk of developing ICD with dopaminergic medication.

  16. Impulsivity in remitted depression: a meta-analytical review.

    Science.gov (United States)

    Saddichha, Sahoo; Schuetz, Christian

    2014-06-01

    Depressive disorder and suicide have been associated with impulsivity in several studies. This paper aimed to review measures of trait impulsivity in remitted depressive disorder. We used keywords "impulsivity and depression"; "impulsivity and depressive disorder" to narrow down our search on Medline, EMBASE and Psychinfo to include those studies that had reported impulsivity scores using validated and reliable assessment measures in remitted depressive disorder. We searched all English language studies from 1990 to December 2012 with 9 reports meeting the inclusion criteria for depression, which were then reviewed by the two reviewers independently. We generated weighted mean differences (WMDs) for depression from the pooled data using RevManager 5.1 from Cochrane analysis. The Barratt Impulsivity Scale (BIS) 11 was the instrument commonly used in depression. 9 studies met inclusion criteria in depression, which yielded a WMD of 10.12 on BIS 11 total scores. There is a strong association of impulsivity and depression, which persists even in remission. Copyright © 2014 Elsevier B.V. All rights reserved.

  17. Alexithymia, impulsiveness, and psychopathology in nonsuicidal self-injured adolescents

    Directory of Open Access Journals (Sweden)

    Gatta M

    2016-09-01

    Full Text Available Michela Gatta,1 Francesco Dal Santo,1 Alessio Rago,1 Andrea Spoto,2 Pier Antonio Battistella1 1Childhood Adolescence Family Unit, Ulss 16 – Padua University, 2Department of General Psychology, Padua University, Padova, Italy Introduction: Nonsuicidal self-injury (NSSI is a multifaceted phenomenon and a major health issue among adolescents. A better understanding of self-injury comorbidities is crucial to improve our ability to assess, treat, and prevent NSSI.Purpose: This study aimed at analyzing some of the psychobehavioral correlates of NSSI: psychological problems, alexithymia, impulsiveness, and sociorelational aspects.Patients and methods: This was a case–control study. The clinical sample (n=33 included adolescents attending our unit for NSSI and other issues; the controls (n=79 were high-school students. Data were collected using six questionnaires: Youth Self-Report, Barratt’s Impulsiveness Scale, Toronto Alexithymia Scale, Children’s Depression Inventory, Symptom Checklist-90-R, and Child Behavior Checklist.Results: Cases scored significantly higher in all questionnaires. Habitual self-injurers scored higher on impulsiveness and alexithymia. The gesture’s repetition seems relevant to the global clinical picture: habitual self-injurers appear more likely to seek help from the sociosanitary services. We found a difference between the self-injurers’ and their parents’ awareness of the disorder.Conclusion: Habitual self-injurers show signs of having difficulty with assessing the consequences of their actions (nonplanning impulsiveness and the inability to manage their feelings. Given the significantly higher scores found for cases than for controls on all the psychopathological scales, NSSI can be seen as a cross-category psychiatric disorder, supporting the Diagnostic and Statistical Manual of Mental Disorders decision to include it as a pathological entity in its own right. Keywords: NSSI, self-cutting, psychiatric

  18. Neural Correlates of Impulsivity in Healthy Males and Females with Family Histories of Alcoholism

    Science.gov (United States)

    DeVito, Elise E; Meda, Shashwath A; Jiantonio, Rachel; Potenza, Marc N; Krystal, John H; Pearlson, Godfrey D

    2013-01-01

    Individuals family-history positive (FHP) for alcoholism have increased risk for the disorder, which may be mediated by intermediate behavioral traits such as impulsivity. Given the sex differences in the risk for and clinical presentation of addictive disorders, risk for addiction may be differentially mediated by impulsivity within FHP males and females. FHP (N=28) and family-history negative (FHN, N=31) healthy, non-substance-abusing adults completed an fMRI Go/No-Go task and were assessed on impulsivity and alcohol use. Effects of family history and sex were investigated as were associations between neural correlates of impulse control and out-of-scanner measures of impulsivity and alcohol use. FHP individuals showed greater activation in the left anterior insula and inferior frontal gyrus during successful inhibitions, an effect that was driven primarily by FHP males. Higher self-reported impulsivity and behavioral discounting impulsivity, but not alcohol use measures, were associated with greater BOLD signal in the region that differentiated the FHP and FHN groups. Impulsivity factors were associated with alcohol use measures across the FHP and FHN groups. These findings are consistent with increased risk for addiction among FHP individuals being conferred through disrupted function within neural systems important for impulse control. PMID:23584260

  19. Brain PET substrate of impulse control disorders in Parkinson's disease: A metabolic connectivity study.

    Science.gov (United States)

    Verger, Antoine; Klesse, Elsa; Chawki, Mohammad B; Witjas, Tatiana; Azulay, Jean-Philippe; Eusebio, Alexandre; Guedj, Eric

    2018-04-10

    Impulse control disorders (ICDs) have received increased attention in Parkinson's disease (PD) because of potentially dramatic consequences. Their physiopathology, however, remains incompletely understood. An overstimulation of the mesocorticolimbic system has been reported, while a larger network has recently been suggested. The aim of this study is to specifically describe the metabolic PET substrate and related connectivity changes in PD patients with ICDs. Eighteen PD patients with ICDs and 18 PD patients without ICDs were evaluated using cerebral 18F-fluorodeoxyglucose positron emission tomography. SPM-T maps comparisons were performed between groups and metabolic connectivity was evaluated by interregional correlation analysis (IRCA; p  130) and by graph theory (p < .05). PD patients with ICDs had relative increased metabolism in the right middle and inferior temporal gyri compared to those without ICDs. The connectivity of this area was increased mostly with the mesocorticolimbic system, positively with the orbitofrontal region, and negatively with both the right parahippocampus and the left caudate (IRCA). Moreover, the betweenness centrality of this area with the mesocorticolimbic system was lost in patients with ICDs (graph analysis). ICDs are associated in PD with the dysfunction of a network exceeding the mesocorticolimbic system, and especially the caudate, the parahippocampus, and the orbitofrontal cortex, remotely including the right middle and inferior temporal gyri. This latest area loses its central place with the mesocorticolimbic system through a connectivity dysregulation. © 2018 Wiley Periodicals, Inc.

  20. Gender-specific suicide risk factors: a case-control study of individuals with major depressive disorder.

    Science.gov (United States)

    Dalca, Ioana Mioara; McGirr, Alexander; Renaud, Johanne; Turecki, Gustavo

    2013-12-01

    Available information on risk for suicide completion in females is limited and often extrapolated from studies conducted in males. However, the validity of extending to females risk factors identified among male suicide cases is unclear. In this study, we aimed to investigate clinical and behavioral risk factors for suicide among female depressed patients and compare them to similar factors among male depressed patients. We identified 201 suicide completers (160 male and 41 female) who died during an episode of major depressive disorder (MDD). Cases were compared to 127 living patients with MDD (88 male and 39 female). All subjects were characterized for Axis I and II diagnoses using the Structured Clinical Interview for DSM-IV Axis I Disorders and Structured Clinical Interview for DSM-IV Axis II Personality Disorders according to the DSM-IV, as well as behavioral and temperament dimensions using proxy-based interviews. The primary outcome was measures of impulsive and impulsive-aggressive behaviors. Compared to controls, male, but not female suicide cases had higher levels of impulsive aggression (P suicide cases from controls. However, nonimpulsive aggression and impulsive aggression were correlated constructs in males (r = 0.297; P suicide, such as alcohol and substance dependence, cluster B disorders, and elevated hostility and aggression, were replicated in the pooled-sex analyses, and, though not statistically significant in discriminating between suicide cases and controls by gender, maintained strong group differences. Males and females share many risk factors for suicide in MDD, yet alcohol dependence is much more specific though less sensitive among depressed females. Nonimpulsive aggression is part of a diathesis for suicide in females, which is distinct from the well-characterized impulsive aggression that is consistently reported in a portion of male suicide cases. © Copyright 2013 Physicians Postgraduate Press, Inc.

  1. Impulse Control Disorders in Parkinson's Disease are Associated with Alterations in Reward-Related Cortical Oscillations.

    Science.gov (United States)

    Carriere, Nicolas; Bourriez, Jean-Louis; Delval, Arnaud; Derambure, Philippe; Defebvre, Luc; Dujardin, Kathy

    2016-06-28

    Impulse control disorders (ICDs) in Parkinson's disease (PD) are related to treatment with dopamine agonists, which is thought to deregulate the dopaminergic mesolimbic pathway and impair reward evaluation. EEG studies in healthy controls (HCs) have suggested that the increase in theta power observed after negative outcome is a marker of reward processing. To compare outcome-locked, event-related spectral perturbation in a gambling task in PD patients with and without ICDs and in HCs. Twelve PD patients with ICDs, 12 PD patients without ICDs and 14 HCs underwent EEG while performing a gambling task. The groups were compared in terms of (i) the peak EEG power in the theta (4-7 Hz), alpha (8-14 Hz) and beta (15-30 Hz) frequency bands between 200 and 500 ms after the outcome, and (ii) time-frequency plots at Fz, FCz and Cz. Positive outcomes were associated with greater theta power than negative outcomes in patients without ICDs and in HCs, but not in patients with ICDs. Patients with ICDs and HCs displayed greater theta power following unexpectedly high outcomes. HCs displayed greater beta power following high amplitude than low amplitude outcomes, whereas patients with ICD showed the opposite pattern. In PD, ICDs are associated with (i) weaker modulation of frontocentral theta power by reward valence, (ii) greater frontocentral theta power following unexpected, high outcomes, and (iii) a reversal of the effect of risk on beta oscillations. These observations are consistent with an impairment in prediction error computation in the medial prefrontal cortex.

  2. Impaired decision-making and impulse control in Internet gaming addicts: evidence from the comparison with recreational Internet game users.

    Science.gov (United States)

    Wang, Yifan; Wu, Lingdan; Wang, Lingxiao; Zhang, Yifen; Du, Xiaoxia; Dong, Guangheng

    2017-11-01

    Although Internet games have been proven to be addictive, only a few game players develop online gaming addiction. A large number of players play online games recreationally without being addicted to it. These individuals are defined as recreational Internet gaming users (RGU). So far, no research has investigated decision-making and impulse control in RGU. In the current study, we used delay discounting (DD) task and probabilistic discounting (PD) task to examine decision-making and impulse control in 20 healthy controls, 20 subjects with Internet gaming disorder (IGD) and 23 RGU during fMRI scanning. At the behavioral level, RGU showed lower DD rate and higher PD rate than subjects with IGD and there was no significant difference between RGU and healthy controls on the DD and PD rates. At the neural level, RGU showed increased neural response in the parahippocampal gyrus, the anterior cingulate cortex, the medial frontal gyrus and the inferior frontal gyrus as compared with subjects with IGD. These brain regions may play an important role in preventing RGU from developing addiction. The results suggest that the RGU are capable of inhibiting impulse due to additional cognitive endeavor and the subjects with IGD have deficit in decision-making and impulsive control, which are associated with brain dysfunction. © 2016 Society for the Study of Addiction.

  3. Impulsive-aggressive behaviours and completed suicide across the life cycle: a predisposition for younger age of suicide.

    Science.gov (United States)

    McGirr, A; Renaud, J; Bureau, A; Seguin, M; Lesage, A; Turecki, G

    2008-03-01

    It is unclear whether the association between impulsive-aggressive behaviours and suicide exists across different ages. Via psychological autopsy, we examined a total of 645 subjects aged 11-87 years who died by suicide. Proxy-based interviews were conducted using the SCID-I & SCID-II or K-SADS interviews and a series of behavioural and personality-trait assessments. Secondarily, 246 living controls were similarly assessed. Higher levels of impulsivity, lifetime history of aggression, and novelty seeking were associated with younger age of death by suicide, while increasing levels of harm avoidance were associated with increasing age of suicide. This effect was observed after accounting for age-related psychopathology (current and lifetime depressive disorders, lifetime anxiety disorders, current and lifetime substance abuse disorders, psychotic disorders and cluster B personality disorders). Age effects were not due to the characteristics of informants, and such effects were not observed among living controls. When directly controlling for major psychopathology, the interaction between age, levels of impulsivity, aggression and novelty seeking predicted suicide status while controlling for the independent contributions of age and these traits. Higher levels of impulsive-aggressive traits play a greater role in suicide occurring among younger individuals, with decreasing importance with increasing age.

  4. The effects of trait impulsivity on proactive and reactive interference control.

    Science.gov (United States)

    Xiang, Ling; Chen, Yan; Chen, Antao; Zhang, Fenghua; Xu, Fuming; Wang, Baoxi

    2018-02-01

    The current study used event-related brain potentials (ERPs) to explore whether self-reported trait impulsivity in healthy individuals might be differentially related to proactive and reactive interference control. Participants with high and low impulsivity (HI and LI, respectively) performed a modified version of the prime-target interference task. Proactive interference control was induced in the mostly incongruent (MI) context and reactive interference control was induced in the mostly congruent (MC) context. Although the behavioral data revealed no difference between HI and LI individuals in terms of the interference effects (incongruent - congruent) under both contexts, the ERP results showed that impulsivity has a different influence on the interference effects under different task contexts. In the MC context, the interference effects on the medial frontal negativity (MFN) and the negative sustained potential (N-SP) were greater, while that on the positive sustained potential (P-SP) were smaller in the HI compared to those in the LI group. This suggests that high levels of impulsivity might be associated with a reduced efficiency of the processes supporting reactive control to resolve interference when interference is not expected. In contrast, the three ERP indices (MFN, P-SP, and N-SP) of interference processing in the MI context were insensitive to variations in impulsivity. This suggests that HI individuals might be as effective as LI individuals in recruiting proactive control for sustained active maintenance of task goals to anticipate and prevent interference throughout the experimental blocks where interference occurs frequently. In conclusion, these results indicate that impulsivity has a more negative influence on reactive interference control than on proactive interference control. Copyright © 2017. Published by Elsevier B.V.

  5. Internal ellipsoidal estimates of reachable set of impulsive control systems

    Energy Technology Data Exchange (ETDEWEB)

    Matviychuk, Oksana G. [Institute of Mathematics and Mechanics, Russian Academy of Sciences, 16 S. Kovalevskaya str., Ekaterinburg, 620990, Russia and Ural Federal University, 19 Mira str., Ekaterinburg, 620002 (Russian Federation)

    2014-11-18

    A problem of estimating reachable sets of linear impulsive control system with uncertainty in initial data is considered. The impulsive controls in the dynamical system belong to the intersection of a special cone with a generalized ellipsoid both taken in the space of functions of bounded variation. Assume that an ellipsoidal state constraints are imposed. The algorithms for constructing internal ellipsoidal estimates of reachable sets for such control systems and numerical simulation results are given.

  6. Firing Control Optimization of Impulse Thrusters for Trajectory Correction Projectiles

    Directory of Open Access Journals (Sweden)

    Min Gao

    2015-01-01

    Full Text Available This paper presents an optimum control scheme of firing time and firing phase angle by taking impact point deviation as optimum objective function which takes account of the difference of longitudinal and horizontal correction efficiency, firing delay, roll rate, flight stability, and so forth. Simulations indicate that this control scheme can assure lateral impulse thrusters are activated at time and phase angle when the correction efficiency is higher. Further simulations show that the impact point dispersion is mainly influenced by the total impulse deployed, and the impulse, number, and firing interval need to be optimized to reduce the impact point dispersion of rockets. Live firing experiments with two trajectory correction rockets indicate that the firing control scheme works effectively.

  7. Parkinson’s Disease Impulsive-Compulsive Disorders Questionnaire – Current Short (QUIP-CS – Translation and validation of content of Portuguese Version

    Directory of Open Access Journals (Sweden)

    Débora Mascella Krieger

    Full Text Available ABSTRACT Objective Parkinson’s disease (PD management is usually successfully reached with proper pharmacological treatment. However, PD patients can manifest neuropsychiatric symptoms secondary to medical therapy, including impulse control disorders (ICD, presenting as pathological gambling, hypersexuality, compulsive buying, drinking or eating disorders. We translated and validated the Portuguese version of the gold-standard questionnaire Parkinson’s Disease Impulsive-Compulsive Disorders Questionnaire, or (QUIP for identifying ICDs in PD patients. Methods Translation, back translation and submission to instrument developer was performed, that approved its new version comparing it to his original, validated version, with no loss of it’s original properties. Then, the Portuguese version was administered to 30 PD patients. They also were asked to rate from 1 to 5 the level of comprehensibility of the questions. Results The average level of comprehension was 4.06 ± 0.69 DP, considering 3 or more as acceptable. No patient has answered 1 or 2. Conclusion Our results on Portuguese version of QUIP-CS show that QUIP-CS translated and corrected version was easily understood and easily self-applied.

  8. ADHD symptoms in non-treatment seeking young adults: relationship with other forms of impulsivity.

    Science.gov (United States)

    Chamberlain, Samuel R; Ioannidis, Konstantinos; Leppink, Eric W; Niaz, Faiza; Redden, Sarah A; Grant, Jon E

    2017-02-01

    Attention-deficit hyperactivity disorder (ADHD) has been associated with various manifestations of impulsivity in adults, including elevated rates of other impulsive disorders, substance use, questionnaire-based impulsivity scores, and inhibitory dysregulation on neurocognitive tests. The relationship between ADHD and all these other forms of impulsivity has yet to be explored within the context of a single comprehensive study. A total of 423 young adults, who gambled ≥5 times in the preceding year, were recruited using media advertisements and undertook detailed assessment including structured psychiatric interview, questionnaires, and neurocognitive tests. Participants with ADHD symptoms were identified using the Adult ADHD Self-Report Scale Screener (ASRS-V1.1) and were compared to controls using multivariate analysis of variance (MANOVA). ADHD symptoms were found in 20.3% of the sample, but only 7.3% of these subjects had ever received a formal diagnosis. ADHD symptoms were associated with significantly lower quality of life, lower self-esteem, higher emotional dysregulation, higher impulsivity questionnaire scores, more problematic Internet use, greater occurrence of psychiatric disorders, and impaired stop-signal reaction times. Of these variables, stop-signal reaction times and Barratt attentional impulsiveness were the strongest predictors of group classification. ADHD symptoms are common and under-diagnosed in young adults who gamble, and are most strongly linked with certain other types of impulsivity (questionnaire- and cognitive-based measures) and with emotional dysregulation, suggesting that these are each important considerations in understanding the pathophysiology of the disorder, but also potential treatment targets. It is necessary to question whether treatment for adult ADHD could be enhanced by considering self-esteem, emotional reactivity, and impaired inhibitory control as specific treatment targets, in addition to the core diagnostic

  9. Data-driven analysis of simultaneous EEG/fMRI reveals neurophysiological phenotypes of impulse control.

    Science.gov (United States)

    Schmüser, Lena; Sebastian, Alexandra; Mobascher, Arian; Lieb, Klaus; Feige, Bernd; Tüscher, Oliver

    2016-09-01

    Response inhibition is the ability to suppress inadequate but prepotent or ongoing response tendencies. A fronto-striatal network is involved in these processes. Between-subject differences in the intra-individual variability have been suggested to constitute a key to pathological processes underlying impulse control disorders. Single-trial EEG/fMRI analysis allows to increase sensitivity for inter-individual differences by incorporating intra-individual variability. Thirty-eight healthy subjects performed a visual Go/Nogo task during simultaneous EEG/fMRI. Of 38 healthy subjects, 21 subjects reliably showed Nogo-related ICs (Nogo-IC-positive) while 17 subjects (Nogo-IC-negative) did not. Comparing both groups revealed differences on various levels: On trait level, Nogo-IC-negative subjects scored higher on questionnaires regarding attention deficit/hyperactivity disorder; on a behavioral level, they displayed slower response times (RT) and higher intra-individual RT variability while both groups did not differ in their inhibitory performance. On the neurophysiological level, Nogo-IC-negative subjects showed a hyperactivation of left inferior frontal cortex/insula and left putamen as well as significantly reduced P3 amplitudes. Thus, a data-driven approach for IC classification and the resulting presence or absence of early Nogo-specific ICs as criterion for group selection revealed group differences at behavioral and neurophysiological levels. This may indicate electrophysiological phenotypes characterized by inter-individual variations of neural and behavioral correlates of impulse control. We demonstrated that the inter-individual difference in an electrophysiological correlate of response inhibition is correlated with distinct, potentially compensatory neural activity. This may suggest the existence of electrophysiologically dissociable phenotypes of behavioral and neural motor response inhibition with the Nogo-IC-positive phenotype possibly providing

  10. Model Predictive Control based on Finite Impulse Response Models

    DEFF Research Database (Denmark)

    Prasath, Guru; Jørgensen, John Bagterp

    2008-01-01

    We develop a regularized l2 finite impulse response (FIR) predictive controller with input and input-rate constraints. Feedback is based on a simple constant output disturbance filter. The performance of the predictive controller in the face of plant-model mismatch is investigated by simulations...... and related to the uncertainty of the impulse response coefficients. The simulations can be used to benchmark l2 MPC against FIR based robust MPC as well as to estimate the maximum performance improvements by robust MPC....

  11. Role of impulsivity and other personality dimensions in attempted suicide with self-poisoning among children and adolescents.

    Science.gov (United States)

    Ghanem, Mohamed; Gamaluddin, Hany; Mansour, Mona; Samiee', Afaf Abdel; Shaker, Nermin Mahmoud; El Rafei, Heba

    2013-01-01

    The objective of this study was to clarify the role of impulsivity and personality dimensions in attempted suicide among youth. The study included 120 youths who attempted suicide and 100 matched controls. Attempters of suicide had higher total scores and subscales of impulsivity than controls. They had higher novelty seeking, harm avoidance, and reward dependence scores, lower scores on persistence, self-directedness, and cooperativeness. A total of 77.5% of suicide attempters had psychiatric disorders compared to 2% of controls. Main factors predicting the occurrence of suicidal attempts were the presence of psychiatric disorder, impulsivity, stressful life events, and high reward dependence of suicide attempters. The study supports that impulsivity and personality traits play an important role in youth suicide independently or as a part of other interacting factors.

  12. Impulse control disorders in Parkinson's disease: don't set your mind at rest by self-assessments.

    Science.gov (United States)

    Baumann-Vogel, H; Valko, P O; Eisele, G; Baumann, C R

    2015-04-01

    Impulse control disorders (ICDs) and related conditions in Parkinson's disease (PD) patients are frequent, disabling and sometimes devastating neuropsychiatric behaviors. Current knowledge on the prevalence of ICDs in PD is mainly based on assessments with questionnaires or patient interviews. This study was designed to evaluate the reliability of self-assessed ICDs and related conditions in PD by exploring the agreement between self-assessment of ICDs and related conditions in PD patients on the one hand and the estimation of their caregivers on the other hand. After a short validation study of a novel ICD screening questionnaire, a cross-sectional study in 150 PD patients was performed. All patients filled out the self-assessment version of a screening questionnaire for ICDs, and caregivers completed an adapted version (n = 64). When comparing self-assessments of PD patients and ratings by their caregivers, significant differences with regard to the estimated prevalence of hypersexuality (55% vs. 17%), dopamine dysregulation syndrome (31% vs. 3%) and punding (22% vs. 9%) were found. Patients underestimate the presence and severity of some ICDs and related conditions, which shows how important assessments with caregivers are. After all, ICDs are probably much more frequent in PD than previously reported. © 2015 EAN.

  13. Impulsivity and compulsive buying are associated in a non-clinical sample: an evidence for the compulsivity-impulsivity continuum?

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    Jonas J. de Paula

    2015-09-01

    Full Text Available Objective:Compulsive buying is controversial in clinical psychiatry. Although it is defined as an obsessive-compulsive disorder, other personality aspects besides compulsivity are related to compulsive buying. Recent studies suggest that compulsivity and impulsivity might represent a continuum, with several psychiatric disorders lying between these two extremes. In this sense, and following the perspective of dimensional psychiatry, symptoms of impulsivity and compulsivity should correlate even in a non-clinical sample. The present study aims to investigate whether these two traits are associated in a healthy adult sample.Methods:We evaluated 100 adults, with no self-reported psychiatric disorders, using the Barratt Impulsiveness Scale-11 and two scales of compulsive buying.Results:Using multiple linear regressions, we found that impulsivity accounted for about 15% of variance in the compulsive-buying measure.Conclusions:Our results suggest that an association between impulsivity and compulsive buying occurs even in non-clinical samples, evidence that compulsivity and impulsivity might form a continuum and that compulsive buying might be an intermediate condition between these two personality traits.

  14. Deficits in executive and memory processes in delusional disorder: a case-control study.

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    Ibanez-Casas, Inmaculada; De Portugal, Enrique; Gonzalez, Nieves; McKenney, Kathryn A; Haro, Josep M; Usall, Judith; Perez-Garcia, Miguel; Cervilla, Jorge A

    2013-01-01

    Delusional disorder has been traditionally considered a psychotic syndrome that does not evolve to cognitive deterioration. However, to date, very little empirical research has been done to explore cognitive executive components and memory processes in Delusional Disorder patients. This study will investigate whether patients with delusional disorder are intact in both executive function components (such as flexibility, impulsivity and updating components) and memory processes (such as immediate, short term and long term recall, learning and recognition). A large sample of patients with delusional disorder (n = 86) and a group of healthy controls (n = 343) were compared with regard to their performance in a broad battery of neuropsychological tests including Trail Making Test, Wisconsin Card Sorting Test, Colour-Word Stroop Test, and Complutense Verbal Learning Test (TAVEC). When compared to controls, cases of delusional disorder showed a significantly poorer performance in most cognitive tests. Thus, we demonstrate deficits in flexibility, impulsivity and updating components of executive functions as well as in memory processes. These findings held significant after taking into account sex, age, educational level and premorbid IQ. Our results do not support the traditional notion of patients with delusional disorder being cognitively intact.

  15. Lower Monoamine Oxidase-A Total Distribution Volume in Impulsive and Violent Male Offenders with Antisocial Personality Disorder and High Psychopathic Traits: An [(11)C] Harmine Positron Emission Tomography Study.

    Science.gov (United States)

    Kolla, Nathan J; Matthews, Brittany; Wilson, Alan A; Houle, Sylvain; Bagby, R Michael; Links, Paul; Simpson, Alexander I; Hussain, Amina; Meyer, Jeffrey H

    2015-10-01

    Antisocial personality disorder (ASPD) often presents with highly impulsive, violent behavior, and pathological changes in the orbitofrontal cortex (OFC) and ventral striatum (VS) are implicated. Several compelling reasons support a relationship between low monoamine oxidase-A (MAO-A), an enzyme that regulates neurotransmitters, and ASPD. These include MAO-A knockout models in rodents evidencing impulsive aggression and positron emission tomography (PET) studies of healthy subjects reporting associations between low brain MAO-A levels and greater impulsivity or aggression. However, a fundamental gap in the literature is that it is unknown whether brain MAO-A levels are low in more severe, clinical disorders of impulsivity, such as ASPD. To address this issue, we applied [(11)C] harmine PET to measure MAO-A total distribution volume (MAO-A VT), an index of MAO-A density, in 18 male ASPD participants and 18 age- and sex-matched controls. OFC and VS MAO-A VT were lower in ASPD compared with controls (multivariate analysis of variance (MANOVA): F2,33=6.8, P=0.003; OFC and VS MAO-A VT each lower by 19%). Similar effects were observed in other brain regions: prefrontal cortex, anterior cingulate cortex, dorsal putamen, thalamus, hippocampus, and midbrain (MANOVA: F7,28=2.7, P=0.029). In ASPD, VS MAO-A VT was consistently negatively correlated with self-report and behavioral measures of impulsivity (r=-0.50 to -0.52, all P-valuesdisorder marked by pathological aggression and impulsivity.

  16. Impulsive control and synchronization of chaotic Hindmarsh-Rose models for neuronal activity

    International Nuclear Information System (INIS)

    Wu Quanjun; Zhou Jin; Xiang Lan; Liu Zengrong

    2009-01-01

    The issues of impulsive control and synchronization of chaotic Hindmarsh-Rose model are investigated in this paper. Based on impulsive control theory of dynamical systems, some simple yet less conservative criteria ensuring impulsive stabilization and synchronization of the Hindmarsh-Rose models are derived analytically. Furthermore, two numerical results are presented to demonstrate the effectiveness of the proposed control techniques. It is shown that the obtained results should be helpful to understand dynamical mechanism of signal encoding and transduction from information processing of real neuronal activity.

  17. Cognition and impulsivity in adults with attention deficit hyperactivity disorder with and without cocaine and/or crack dependence.

    Science.gov (United States)

    Miguel, Carmen S; Martins, Paula A; Moleda, Nathalya; Klein, Margarete; Chaim-Avancini, Tiffany; Gobbo, Maria A; Alves, Tania M; Silva, Maria A; Louzã, Mario R

    2016-03-01

    Substance use disorder (SUD) is a common comorbidity in adults with attention deficit-hyperactivity disorder (ADHD). However,there have been few studies on cognitive profiles of these patients. Impulsivity is also commonly increased in both disorders. The central aim of this study was to compare cognition and impulsivity in subjects who had ADHD and cocaine dependence (ADHD+COC group) to those with ADHD only (ADHD-noSUD group). We hypothesized that the ADHD+COC group would show more marked cognitive dysfunction and greater impulsivity than their counterparts with ADHD only. A total of 70 adult patients diagnosed with ADHD according to (DSM-IV-TR) criteria were enrolled; 36 with ADHD+COC and 34 with ADHD-noSUD. All study participants were evaluated with a sociodemographic questionnaire; the Mini International Neuropsychiatric Interview; the Adult ADHD Self-Report Scale; the Addiction Severity Index; the Alcohol, Smoking and Substance Involvement Screening Test; the Barratt Impulsiveness Scale; and a comprehensive neurocognitive battery. Compared to individuals with ADHD-noSUD, ADHD+COC individuals had significantly lower mean IQ and higher motor impulsivity. On average, the ADHD+COC group also performed more poorly on tasks assessing verbal skills, vigilance, implicit learning during decision making, and ADHD-noSUD performed more poorly on selective attention, information processing, and visual search. Our results support the integrative theory of ADHD based on the cognitive and affective neuroscience model, and suggests that ADHD-noSUD patients have impairments in cognitive regulation, while ADHD+COC patients have impairments in both cognitive and affective regulation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. Impulsivity and Stress Response in Pathological Gamblers During the Trier Social Stress Test.

    Science.gov (United States)

    Maniaci, G; Goudriaan, A E; Cannizzaro, C; van Holst, R J

    2018-03-01

    Gambling has been associated with increased sympathetic nervous system output and stimulation of the hypothalamic-pituitary-adrenal axis. However it is unclear how these systems are affected in pathological gambling. This study aimed to investigate the effect of the Trier Social Stress Test (TSST) on cortisol and on cardiac interbeat intervals in relation to impulsivity, in a sample of male pathological gamblers compared to healthy controls. In addition, we investigated the correlation between the TSST, duration of the disorder and impulsivity. A total of 35 pathological gamblers and 30 healthy controls, ranging from 19 to 58 years old and all male, participated in this study. Stress response was measured during and after the TSST by salivary cortisol and cardiac interbeat intervals; impulsivity was assessed with the Barratt Impulsiveness Scale (BIS-11). Exposure to the TSST produced a significant increase in salivary cortisol and interbeat intervals in both groups, without differences between groups. We found a negative correlation between baseline cortisol and duration of pathological gambling indicating that the longer the duration of the disorder the lower the baseline cortisol levels. Additionally, we found a main effect of impulsivity across groups on interbeat interval during the TSST, indicating an association between impulsivity and the intensity of the neurovegetative stress response during the TSST. Involvement of the hypothalamic-pituitary-adrenal axis in pathological gambling was confirmed together with evidence of a correlation between length of the disorder and diminished baseline cortisol levels. Impulsivity emerged as a personality trait expressed by pathological gamblers; however the neurovegetative response to the TSST, although associated with impulsivity, appeared to be independent of the presence of pathological gambling.

  19. The Effectiveness of Cognitive Behavior Therapy of Impulse Control on Reduction of Impulsiveness, Crave of Usage and Addiction Severity among Crack Users

    Directory of Open Access Journals (Sweden)

    Rohollah Hadadi

    2009-08-01

    Full Text Available Introduction: The present study was done in order to study of the effectiveness of CBT of impulse control on the reduction of impulsiveness, crave of usage and addiction severity of Crack users. Method: In a quasi experimental design 30 Crack addict users who were treating with Methadone in a clinic selected by interview method and consideration of entrance criterions. Then they allocated to two groups (15 subjects for each group as a witness and experimental groups. The experimental group was under Methadone drug therapy and CBT of impulse control for 8 sessions, and 60 min for each session. But witness group was under Methadone drug therapy and there was not any other intervention. All participants in research were examined before and after treatment by three scales namely: Bart's Impulsiveness Scale, Tifani's Crave Usage, and Addiction Severity Index. MANCOVA was run for analyzing of data. Results: The results showed that significant difference between two groups on impulsiveness subscales crave usage, and addiction severity (except of medical status, job status, law status, and family status. Conclusion: It can say CBT of impulse control can be effective on the reduction of impulsiveness, crave usage and addiction severity in Crack users.

  20. Differences in Inhibitory Control between Impulsive and Premeditated Aggression in Juvenile Inmates

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    Zhuo Zhang

    2017-07-01

    Full Text Available Inhibitory control dysfunction was considered a universal characteristic of violent offenders. The aim of this study was to examine differences in inhibitory control between two subtypes of violent youth; those displaying predominantly impulsive and those presenting predominantly premeditated aggression (PM. Forty-four juvenile offenders, defined on the basis of the Procedures for the Classification of Aggressive/Violent Acts (Stanford and Barratt, 2001 participated (N = 23: impulsive; N = 21 premeditated. A visual Go/NoGo task was used to compare behavioral responses and event-related potentials (ERPs between groups. The task contained two letters (W and M, W was the Go stimulus and M the NoGo stimulus. The impulsive youth showed a significantly greater decrease in N2 latency for Go relative to NoGo trials than the premeditated aggressive youth. The differentiation in N2 amplitude between Go and NoGo (N2d was negatively correlated with impulsivity of aggression. Both groups showed no significant central NoGo P3. Our findings suggest that impulsive violent youth show stronger prepotent responses and impaired conflict monitoring during early inhibitory control processing relative to premeditated aggressive youth. Both impulsive and premeditated violent youth may show impaired response inhibition at the late processing stage of inhibitory control.

  1. Functional and dysfunctional impulsivity and attempted suicide in rural China: A paired case-control study.

    Science.gov (United States)

    Liu, Yang-Yang; Wang, Xin-Ting; Qiu, Hui-Min; Xu, Ai-Qiang; Jia, Cun-Xian

    2017-07-01

    This study aimed to clarify the relationship between functional and dysfunctional impulsivity and attempted suicide in rural China. Data of this study came from the investigation of 407 suicide attempters and their paired non-suicide attempters matched with the same gender, age (±3 years) and residence area in six counties in rural Shandong, China. Suicide attempters accounted for a lower proportion on high functional impulsivity, but a higher proportion on high dysfunctional impulsivity than non-suicide attempters. Dysfunctional impulsivity in the male denoted a significant risk factor for attempted suicide, even after adjustment for psychiatric disorder and demographic factors. Suicide attempters with high dysfunctional impulsivity had a higher percent of family suicide history than those with low dysfunctional impulsivity. High functional impulsivity was a significant protective factor for attempted suicide in the group aged 35-59 years, but a significant risk factor in the group aged 15-34 years. Suicide attempters with low functional impulsivity had poorer economic status and older age than those with high functional impulsivity. Our findings support the key roles of functional and dysfunctional impulsivity in attempted suicide among rural residents of China. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  2. The Role of Working Memory for Cognitive Control in Anorexia Nervosa versus Substance Use Disorder

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    Samantha J. Brooks

    2017-09-01

    Full Text Available Prefrontal cortex executive functions, such as working memory (WM interact with limbic processes to foster impulse control. Such an interaction is referred to in a growing body of publications by terms such as cognitive control, cognitive inhibition, affect regulation, self-regulation, top-down control, and cognitive–emotion interaction. The rising trend of research into cognitive control of impulsivity, using various related terms reflects the importance of research into impulse control, as failure to employ cognitions optimally may eventually result in mental disorder. Against this background, we take a novel approach using an impulse control spectrum model – where anorexia nervosa (AN and substance use disorder (SUD are at opposite extremes – to examine the role of WM for cognitive control. With this aim, we first summarize WM processes in the healthy brain in order to frame a systematic review of the neuropsychological, neural and genetic findings of AN and SUD. In our systematic review of WM/cognitive control, we found n = 15 studies of AN with a total of n = 582 AN and n = 365 HC participants; and n = 93 studies of SUD with n = 9106 SUD and n = 3028 HC participants. In particular, we consider how WM load/capacity may support the neural process of excessive epistemic foraging (cognitive sampling of the environment to test predictions about the world in AN that reduces distraction from salient stimuli. We also consider the link between WM and cognitive control in people with SUD who are prone to ‘jumping to conclusions’ and reduced epistemic foraging. Finally, in light of our review, we consider WM training as a novel research tool and an adjunct to enhance treatment that improves cognitive control of impulsivity.

  3. The Role of Working Memory for Cognitive Control in Anorexia Nervosa versus Substance Use Disorder

    Science.gov (United States)

    Brooks, Samantha J.; Funk, Sabina G.; Young, Susanne Y.; Schiöth, Helgi B.

    2017-01-01

    Prefrontal cortex executive functions, such as working memory (WM) interact with limbic processes to foster impulse control. Such an interaction is referred to in a growing body of publications by terms such as cognitive control, cognitive inhibition, affect regulation, self-regulation, top-down control, and cognitive–emotion interaction. The rising trend of research into cognitive control of impulsivity, using various related terms reflects the importance of research into impulse control, as failure to employ cognitions optimally may eventually result in mental disorder. Against this background, we take a novel approach using an impulse control spectrum model – where anorexia nervosa (AN) and substance use disorder (SUD) are at opposite extremes – to examine the role of WM for cognitive control. With this aim, we first summarize WM processes in the healthy brain in order to frame a systematic review of the neuropsychological, neural and genetic findings of AN and SUD. In our systematic review of WM/cognitive control, we found n = 15 studies of AN with a total of n = 582 AN and n = 365 HC participants; and n = 93 studies of SUD with n = 9106 SUD and n = 3028 HC participants. In particular, we consider how WM load/capacity may support the neural process of excessive epistemic foraging (cognitive sampling of the environment to test predictions about the world) in AN that reduces distraction from salient stimuli. We also consider the link between WM and cognitive control in people with SUD who are prone to ‘jumping to conclusions’ and reduced epistemic foraging. Finally, in light of our review, we consider WM training as a novel research tool and an adjunct to enhance treatment that improves cognitive control of impulsivity. PMID:29018381

  4. Calorie Intake and Gambling: Is Fat and Sugar Consumption 'Impulsive'?

    Science.gov (United States)

    Chamberlain, Samuel R; A Redden, Sarah; Grant, Jon E

    2017-09-01

    Excessive calorie intake constitutes a global public health concern, due to its associated range of untoward outcomes. Gambling is commonplace and gambling disorder is now considered a behavioral addiction in DSM-5. The relationships between calorie intake, gambling, and other types of putatively addictive and impulsive behaviors have received virtually no research attention. Two-hundred twenty-five young adults who gamble were recruited from two Mid-Western university communities in the United States using media advertisements. Dietary intake over the preceding year was quantified using the Dietary Fat and Free Sugar Short questionnaire (DFS). Clinician rating scales, questionnaires, and cognitive tests germane to impulsivity were completed. Relationships between dietary fat/sugar intake and gambling behaviors, as well as other measures of psychopathology and cognition germane to addiction, were evaluated using correlational analyses controlling for multiple comparisons. Greater dietary fat and sugar intake were associated with lower educational levels and with male gender. Controlling for these variables, higher dietary fat and sugar intake were correlated significantly with worse gambling pathology and anxiety scores. Dietary sugar intake was also significantly associated with higher depressive scores, more alcohol intake, lower self-esteem, and with greater risk of having one or more mental disorders in general. Dietary intake did not correlate significantly with ADHD symptoms, presence of one or more impulse control disorders, Barratt impulsiveness, or cognitive functioning. These data suggest a particularly strong relationship between fat/sugar intake and symptoms of gambling pathology, but not most other forms of impulsivity and behavioral addiction (excepting alcohol intake). Providing education about healthy diet may be especially valuable in gamblers and in community settings where gambling advertisements feature prominently. Future work should explore

  5. Role of depression severity and impulsivity in the relationship between hopelessness and suicidal ideation in patients with major depressive disorder.

    Science.gov (United States)

    Wang, Yan-yu; Jiang, Neng-zhi; Cheung, Eric F C; Sun, Hong-wei; Chan, Raymond C K

    2015-09-01

    Hopelessness, depression and impulsivity all contribute to the development of suicidal ideation in patients with major depressive disorder, but the pathway of these factors to suicidal ideation is not clear. This study examined the meditating effect of depression severity on the relationship between hopelessness and suicidal ideation and explored how this mediating effect was moderated by impulsivity. A total of 162 patients with major depressive disorder (MDD) completed a structured clinical diagnostic interview and a battery of scales assessing depression severity, hopelessness, suicidal ideation, and impulsivity. Regression analyses with bootstrapping methods were used to examine the mediating and moderating effects of various risk factors. Mediation analysis revealed a significant indirect effect of hopelessness on suicidal ideation, and the effect was fully mediated through depression severity. On moderation analysis, the moderating effects of the relationship between depression severity and suicidal ideation were significant in both the medium and high impulsivity groups. The present study was limited by the assessment of trait impulsivity and observer-rated depression severity, which might not fully reflect momentary impulsivity and feeling of depression when suicidal ideation occurs. Depression severity plays a mediator role in the relationship between hopelessness and suicidal ideation and this mechanism is contingent on the levels of impulsivity. MDD patients with higher impulsivity appear to be more likely to have suicidal ideations even when they are less depressed. These findings highlight the importance of impulsivity assessment and alleviation of depressive symptoms to prevent suicidality in patients with MDD. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Aspirations, Expectations and Delinquency: The Moderating Effect of Impulse Control.

    Science.gov (United States)

    Mahler, Alissa; Simmons, Cortney; Frick, Paul J; Steinberg, Laurence; Cauffman, Elizabeth

    2017-07-01

    Although prior research finds a robust link between delinquent behavior and expectations, or an adolescent's perceived likelihood of obtaining one's future goals, fewer studies have evaluated aspirations, or the perceived importance of achieving one's goals. In addition, few studies consider how individual traits such as impulsivity affect the degree to which expectations and aspirations motivate or deter delinquent behavior. We contribute to this body of research by evaluating the independent effects of expectations and aspirations, and the aspiration-expectation gap (i.e., strain) on delinquent behavior during the year following an adolescent's first arrest using a large (N = 1117), racially/ethnically diverse sample of male adolescents (46.55% Latino, 35.81% Black, 14.95% White, and 2.69% Other race). In addition, we considered how impulse control interacts with expectations, aspirations, and strain to motivate behavior. Our results indicated that both aspirations, expectations and strain uniquely influence criminal behavior. Importantly, aspirations interacted with impulse control, such that aspirations affected delinquency only among youth with higher impulse control. Our findings suggest that aspirations may only influence behavior if youth also have the psychosocial capabilities to consider their future aspirations when behaving in the present.

  7. The influence of serotonin- and other genes on impulsive behavioral aggression and cognitive impulsivity in children with attention-deficit/hyperactivity disorder (ADHD: Findings from a family-based association test (FBAT analysis

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    Gill Michael

    2008-10-01

    Full Text Available Abstract Background Low serotonergic (5-HT activity correlates with increased impulsive-aggressive behavior, while the opposite association may apply to cognitive impulsiveness. Both types of impulsivity are associated with attention-deficit/hyperactivity disorder (ADHD, and genes of functional significance for the 5-HT system are implicated in this disorder. Here we demonstrate the separation of aggressive and cognitive components of impulsivity from symptom ratings and test their association with 5-HT and functionally related genes using a family-based association test (FBAT-PC. Methods Our sample consisted of 1180 offspring from 607 families from the International Multicenter ADHD Genetics (IMAGE study. Impulsive symptoms were assessed using the long forms of the Conners and the Strengths and Difficulties parent and teacher questionnaires. Factor analysis showed that the symptoms aggregated into parent- and teacher-rated behavioral and cognitive impulsivity. We then selected 582 single nucleotide polymorphisms (SNPs from 14 genes directly or indirectly related to 5-HT function. Associations between these SNPs and the behavioral/cognitive groupings of impulsive symptoms were evaluated using the FBAT-PC approach. Results In the FBAT-PC analysis for cognitive impulsivity 2 SNPs from the gene encoding phenylethanolamine N-methyltransferase (PNMT, the rate-limiting enzyme for adrenalin synthesis attained corrected gene-wide significance. Nominal significance was shown for 12 SNPs from BDNF, DRD1, HTR1E, HTR2A, HTR3B, DAT1/SLC6A3, and TPH2 genes replicating reported associations with ADHD. For overt aggressive impulsivity nominal significance was shown for 6 SNPs from BDNF, DRD4, HTR1E, PNMT, and TPH2 genes that have also been reported to be associated with ADHD. Associations for cognitive impulsivity with a SERT/SLC6A4 variant (STin2: 12 repeats and aggressive behavioral impulsivity with a DRD4 variant (exon 3: 3 repeats are also described

  8. [¹¹C]-(+)-PHNO PET imaging of dopamine D(2/3) receptors in Parkinson's disease with impulse control disorders.

    Science.gov (United States)

    Payer, Doris E; Guttman, Mark; Kish, Stephen J; Tong, Junchao; Strafella, Antonio; Zack, Martin; Adams, John R; Rusjan, Pablo; Houle, Sylvain; Furukawa, Yoshiaki; Wilson, Alan A; Boileau, Isabelle

    2015-02-01

    Dopamine agonist medications with high affinity for the D3 dopamine receptor are commonly used to treat Parkinson's disease, and have been associated with pathological behaviors categorized under the umbrella of impulse control disorders (ICD). The aim of this study was to investigate whether ICD in Parkinson's patients are associated with greater D3 dopamine receptor availability. We used positron emission tomography (PET) radioligand imaging with the D3 dopamine receptor preferring agonist [¹¹C]-(+)-propyl-hexahydro-naphtho-oxazin (PHNO) in Parkinson's patients with (n = 11) and without (n = 21) ICD, and age-, sex-, and education-matched healthy control subjects (n = 18). Contrary to hypotheses, [¹¹C]-(+)-PHNO binding in D3 -rich brain areas was not elevated in Parkinson's patients with ICD compared with those without; instead, [¹¹C]-(+)-PHNO binding in ventral striatum was 20% lower (P = 0.011), correlating with two measures of ICD severity (r = -0.8 and -0.9), which may reflect higher dopamine tone in ventral striatum. In dorsal striatum, where [¹¹C]-(+)-PHNO binding is associated with D2 receptor levels, [¹¹C]-(+)-PHNO binding was elevated across patients compared with controls. We conclude that although D3 dopamine receptors have been linked to the occurrence of ICD in Parkinson's patients. Our findings do not support the hypothesis that D3 receptor levels are elevated in Parkinson's patients with ICD. We also did not find ICD-related abnormalities in D2 receptor levels. Our findings argue against the possibility that differences in D2/3 receptor levels can account for the development of ICD in PD; however, we cannot rule out that differences in dopamine levels (particularly in ventral striatum) may be involved. © 2015 International Parkinson and Movement Disorder Society.

  9. The 5-HTTLPR polymorphism, impulsivity and suicide behavior in euthymic bipolar patients.

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    Malloy-Diniz, Leandro Fernandes; Neves, Fernando Silva; de Moraes, Paulo Henrique Paiva; De Marco, Luiz Armando; Romano-Silva, Marco Aurélio; Krebs, Marie-Odile; Corrêa, Humberto

    2011-09-01

    Suicide behavior is very frequent in Bipolar Disorder (BD) and they are both closely associated with impulsivity. Furthermore they are, impulsivity, BD and suicide behavior, associated with serotonergic function, at least partially, under genetic determinism and somewhat associated with the serotonin transporter gene polymorphism, the 5-HTTLPR. We aimed to assess different impulsivity components in BD sub-grouped by suicidal attempt and healthy controls. We hypothesized that the non-planning/cognitive impulsivity, could be more closely associated with suicidal behavior. We further associated 5-HTTLPR genotypes with neuropsychological results to test the hypothesis that this polymorphism is associated with cognitive impulsivity. We assessed 95 euthymic bipolar patients sub-grouped by suicidal attempt history in comparison with 94 healthy controls. All subjects underwent a laboratory assessment of impulsivity (Continuous Performance Test and Iowa Gambling Test). Furthermore the genotyping of 5-HTTLPR was performed in all subjects. We found that bipolar patients are more impulsive than healthy controls in all impulsivity dimensions we studied. Furthermore bipolar patients with a suicide attempt history have a greater cognitive impulsivity when compared to both bipolar patients without such a history as well when compared to healthy controls. No association was found between 5-HTTLPR genotypes and neuropsychological measures of impulsive behavior. The sample studied can be considered small and a potentially confounding variable - medication status - was not controlled. A lifetime suicide attempt seems associated with cognitive impulsivity independently of the socio-demographic and clinical variables studied as well with 5-HTTLPR genotype. Further studies in larger samples are necessary. Copyright © 2011 Elsevier B.V. All rights reserved.

  10. Statistical Evidence Suggests that Inattention Drives Hyperactivity/Impulsivity in Attention Deficit-Hyperactivity Disorder

    Science.gov (United States)

    Sokolova, Elena; Groot, Perry; Claassen, Tom; van Hulzen, Kimm J.; Glennon, Jeffrey C.; Franke, Barbara

    2016-01-01

    Background Numerous factor analytic studies consistently support a distinction between two symptom domains of attention-deficit/hyperactivity disorder (ADHD), inattention and hyperactivity/impulsivity. Both dimensions show high internal consistency and moderate to strong correlations with each other. However, it is not clear what drives this strong correlation. The aim of this paper is to address this issue. Method We applied a sophisticated approach for causal discovery on three independent data sets of scores of the two ADHD dimensions in NeuroIMAGE (total N = 675), ADHD-200 (N = 245), and IMpACT (N = 164), assessed by different raters and instruments, and further used information on gender or a genetic risk haplotype. Results In all data sets we found strong statistical evidence for the same pattern: the clear dependence between hyperactivity/impulsivity symptom level and an established genetic factor (either gender or risk haplotype) vanishes when one conditions upon inattention symptom level. Under reasonable assumptions, e.g., that phenotypes do not cause genotypes, a causal model that is consistent with this pattern contains a causal path from inattention to hyperactivity/impulsivity. Conclusions The robust dependency cancellation observed in three different data sets suggests that inattention is a driving factor for hyperactivity/impulsivity. This causal hypothesis can be further validated in intervention studies. Our model suggests that interventions that affect inattention will also have an effect on the level of hyperactivity/impulsivity. On the other hand, interventions that affect hyperactivity/impulsivity would not change the level of inattention. This causal model may explain earlier findings on heritable factors causing ADHD reported in the study of twins with learning difficulties. PMID:27768717

  11. Robust lag synchronization between two different chaotic systems via dual-stage impulsive control

    International Nuclear Information System (INIS)

    Hua-Guang, Zhang; Tie-Dong, Ma; Jie, Fu; Shao-Cheng, Tong

    2009-01-01

    In this paper, an improved impulsive lag synchronization scheme for different chaotic systems with parametric uncertainties is proposed. Based on the new definition of synchronization with error bound and a novel impulsive control scheme (the so-called dual-stage impulsive control), some new and less conservative sufficient conditions are established to guarantee that the error dynamics can converge to a predetermined level, which is more reasonable and rigorous than the existing results. In particular, some simpler and more convenient conditions are derived by taking the same impulsive distances and control gains. Finally, some numerical simulations for the Lorenz system and the Chen system are given to demonstrate the effectiveness and feasibility of the proposed method

  12. Latent class analysis of gambling subtypes and impulsive/compulsive associations: Time to rethink diagnostic boundaries for gambling disorder?

    Science.gov (United States)

    Chamberlain, Samuel R; Stochl, Jan; Redden, Sarah A; Odlaug, Brian L; Grant, Jon E

    2017-09-01

    Gambling disorder has been associated with cognitive dysfunction and impaired quality of life. The current definition of non-pathological, problem, and pathological types of gambling is based on total symptom scores, which may overlook nuanced underlying presentations of gambling symptoms. The aims of the current study were (i) to identify subtypes of gambling in young adults, using latent class analysis, based on individual responses from the Structured Clinical Interview for Gambling Disorder (SCI-GD); and (ii) to explore relationships between these gambling subtypes, and clinical/cognitive measures. Total 582 non-treatment seeking young adults were recruited from two US cities, on the basis of gambling five or more times per year. Participants undertook clinical and neurocognitive assessment, including stop-signal, decision-making, and set-shifting tasks. Data from individual items of the Structured Clinical Interview for Gambling Disorder (SCI-GD) were entered into latent class analysis. Optimal number of classes representing gambling subtypes was identified using Bayesian Information Criterion and differences between them were explored using multivariate analysis of variance. Three subtypes of gambling were identified, termed recreational gamblers (60.2% of the sample; reference group), problem gamblers (29.2%), and pathological gamblers (10.5%). Common quality of life impairment, elevated Barratt Impulsivity scores, occurrence of mainstream mental disorders, having a first degree relative with an addiction, and impaired decision-making were evident in both problem and pathological gambling groups. The diagnostic item 'chasing losses' most discriminated recreational from problem gamblers, while endorsement of 'social, financial, or occupational losses due to gambling' most discriminated pathological gambling from both other groups. Significantly higher rates of impulse control disorders occurred in the pathological group, versus the problem group, who in turn

  13. Deficits in executive and memory processes in delusional disorder: a case-control study.

    Directory of Open Access Journals (Sweden)

    Inmaculada Ibanez-Casas

    Full Text Available OBJECTIVE: Delusional disorder has been traditionally considered a psychotic syndrome that does not evolve to cognitive deterioration. However, to date, very little empirical research has been done to explore cognitive executive components and memory processes in Delusional Disorder patients. This study will investigate whether patients with delusional disorder are intact in both executive function components (such as flexibility, impulsivity and updating components and memory processes (such as immediate, short term and long term recall, learning and recognition. METHODS: A large sample of patients with delusional disorder (n = 86 and a group of healthy controls (n = 343 were compared with regard to their performance in a broad battery of neuropsychological tests including Trail Making Test, Wisconsin Card Sorting Test, Colour-Word Stroop Test, and Complutense Verbal Learning Test (TAVEC. RESULTS: When compared to controls, cases of delusional disorder showed a significantly poorer performance in most cognitive tests. Thus, we demonstrate deficits in flexibility, impulsivity and updating components of executive functions as well as in memory processes. These findings held significant after taking into account sex, age, educational level and premorbid IQ. CONCLUSIONS: Our results do not support the traditional notion of patients with delusional disorder being cognitively intact.

  14. Psychopathology and comorbidity of psychiatric disorders in patients with kleptomania.

    Science.gov (United States)

    Baylé, Franck J; Caci, Hervé; Millet, Bruno; Richa, Sami; Olié, Jean-Pierre

    2003-08-01

    This study compared patients with kleptomania, patients with alcohol abuse or dependence, and psychiatric patients without impulse-control disorders or substance-related disorders on several key psychopathological dimensions. In addition, the comorbidity of kleptomania with other psychiatric disorders was examined. Eleven patients with kleptomania recruited over a cumulative 2-year period and 60 patients with alcohol abuse or dependence and 29 psychiatric comparison patients recruited over a consecutive 6-month period participated in structured clinical interviews to determine the presence of impulse-control and substance-related disorders and of other psychiatric disorders that were comorbid with kleptomania. Psychopathological dimensions were measured with the Barratt Impulsiveness Scale, the Sensation Seeking Scale, the Montgomery-Asberg Depression Rating Scale, and the anxiety and depression subscales of the Hospital Anxiety and Depression Scale. Significant group effects were found for the Barratt Impulsiveness Scale total and cognitive impulsivity scores, with the patients with kleptomania having higher impulsivity scores than the other groups. Significant group differences were found on the Sensation Seeking Scale total and disinhibition scores. No significant group effects were found for the mood and anxiety measures. Patients with kleptomania had high rates of comorbid psychiatric disorders, particularly mood disorders, other impulse-control disorders, and substance abuse or dependence (mainly nicotine dependence). Kleptomania presented a specific psychopathological profile that distinguished patients with this disorder from patients with alcohol abuse or dependence and other psychiatric comparison patients. Impulsivity was the major psychopathological feature of kleptomania. A link between kleptomania and affective disorder was supported by the high rate of comorbid affective disorders in patients with kleptomania and a specific pattern of variation in

  15. Cluster synchronization of community network with distributed time delays via impulsive control

    International Nuclear Information System (INIS)

    Leng Hui; Wu Zhao-Yan

    2016-01-01

    Cluster synchronization is an important dynamical behavior in community networks and deserves further investigations. A community network with distributed time delays is investigated in this paper. For achieving cluster synchronization, an impulsive control scheme is introduced to design proper controllers and an adaptive strategy is adopted to make the impulsive controllers unified for different networks. Through taking advantage of the linear matrix inequality technique and constructing Lyapunov functions, some synchronization criteria with respect to the impulsive gains, instants, and system parameters without adaptive strategy are obtained and generalized to the adaptive case. Finally, numerical examples are presented to demonstrate the effectiveness of the theoretical results. (paper)

  16. Mentalization in adults with attention deficit hyperactivity disorder: Comparison with controls and patients with borderline personality disorder.

    Science.gov (United States)

    Perroud, Nader; Badoud, Deborah; Weibel, Sébastien; Nicastro, Rosetta; Hasler, Roland; Küng, Anne-Lise; Luyten, Patrick; Fonagy, Peter; Dayer, Alexandre; Aubry, Jean-Michel; Prada, Paco; Debbané, Martin

    2017-10-01

    Emotion dysregulation and interpersonal hardships constitute core features of borderline personality disorder (BPD). Research has established the link between these core dysregulations and fluctuations in the capacity to appreciate the mental states that underlie behavior (mentalizing, operationalized as reflective functioning (RF)). As emotion dysregulation and interpersonal hardships also characterize adults with attention deficit hyperactivity disorder (ADHD), this study sought to examine the potential RF impairments affecting this population. 101 adults with ADHD, 108 with BPD and 236 controls were assessed using the RF questionnaire (RFQ), evaluating how individuals employ information about mental states to better understand their own and others' behaviors. The RFQ comprises two dimensions, certainty (RF_c) and uncertainty (RF_u) about mental states. RF scores helped distinguish ADHD from controls, but also from BPD (F = 48.1 (2/441) ; p attentional and hyperactive/impulsive symptoms) was correlated with RF impairments. In conclusion, RF may constitute an important process underlying attentional, hyperactive/impulsive as well as emotional symptoms in ADHD; it should therefore be considered in the assessment of these patients. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Reflective and impulsive influences on unhealthy snacking. The moderating effects of food related self-control.

    Science.gov (United States)

    Honkanen, Pirjo; Olsen, Svein Ottar; Verplanken, Bas; Tuu, Ho Huy

    2012-04-01

    This study proposes that snacking behaviour may be either reflective and deliberate or impulsive, thus following a dual-process account. We hypothesised that chronic individual differences in food related self-control would moderate the relationships between reflective and impulsive processes. The reflective route was represented by an attitude toward unhealthy snacking, while the impulsive route was represented by the tendency to buy snack on impulse. A web survey was conducted with 207 students and employees at a Norwegian university, and a moderated hierarchical regression analysis using structural equation modelling was used to estimate the theoretical model. The findings showed that both attitudes towards unhealthy snacking and impulsive snack buying tendency were positively related to snack consumption. Food related self-control moderated the relation between attitude and behaviour, as well as the relation between impulsive snack buying tendency and behaviour. The effect of attitude on consumption was relatively strong when food related self-control was strong, while the effect of impulsive snack buying on consumption was relatively strong when food related self-control was weak. The results thus suggest that while weak self-control exposes individuals vulnerable to impulsive tendencies, strong self-control does not necessarily lead to less unhealthy snacking, but this depends on the valence of an individual's attitude. Copyright © 2011 Elsevier Ltd. All rights reserved.

  18. Mu and delta opioid receptors oppositely regulate motor impulsivity in the signaled nose poke task.

    Directory of Open Access Journals (Sweden)

    Mary C Olmstead

    Full Text Available Impulsivity is a primary feature of many psychiatric disorders, most notably attention deficit hyperactivity disorder and drug addiction. Impulsivity includes a number of processes such as the inability to delay gratification, the inability to withhold a motor response, or acting before all of the relevant information is available. These processes are mediated by neural systems that include dopamine, serotonin, norepinephrine, glutamate and cannabinoids. We examine, for the first time, the role of opioid systems in impulsivity by testing whether inactivation of the mu- (Oprm1 or delta- (Oprd1 opioid receptor gene alters motor impulsivity in mice. Wild-type and knockout mice were examined on either a pure C57BL6/J (BL6 or a hybrid 50% C57Bl/6J-50% 129Sv/pas (HYB background. Mice were trained to respond for sucrose in a signaled nose poke task that provides independent measures of associative learning (responses to the reward-paired cue and motor impulsivity (premature responses. Oprm1 knockout mice displayed a remarkable decrease in motor impulsivity. This was observed on the two genetic backgrounds and did not result from impaired associative learning, as responses to the cue signaling reward did not differ across genotypes. Furthermore, mutant mice were insensitive to the effects of ethanol, which increased disinhibition and decreased conditioned responding in wild-type mice. In sharp contrast, mice lacking the Oprd1 gene were more impulsive than controls. Again, mutant animals showed no deficit in associative learning. Ethanol completely disrupted performance in these animals. Together, our results suggest that mu-opioid receptors enhance, whereas delta-opioid receptors inhibit, motor impulsivity. This reveals an unanticipated contribution of endogenous opioid receptor activity to disinhibition. In a broader context, these data suggest that alterations in mu- or delta-opioid receptor function may contribute to impulse control disorders.

  19. Neural substrates of trait impulsivity, anhedonia, and irritability: Mechanisms of heterotypic comorbidity between externalizing disorders and unipolar depression.

    Science.gov (United States)

    Zisner, Aimee; Beauchaine, Theodore P

    2016-11-01

    Trait impulsivity, which is often defined as a strong preference for immediate over delayed rewards and results in behaviors that are socially inappropriate, maladaptive, and short-sighted, is a predisposing vulnerability to all externalizing spectrum disorders. In contrast, anhedonia is characterized by chronically low motivation and reduced capacity to experience pleasure, and is common to depressive disorders. Although externalizing and depressive disorders have virtually nonoverlapping diagnostic criteria in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, heterotypic comorbidity between them is common. Here, we review common neural substrates of trait impulsivity, anhedonia, and irritability, which include both low tonic mesolimbic dopamine activity and low phasic mesolimbic dopamine responding to incentives during reward anticipation and associative learning. We also consider how other neural networks, including bottom-up emotion generation systems and top-down emotion regulation systems, interact with mesolimbic dysfunction to result in alternative manifestations of psychiatric illness. Finally, we present a model that emphasizes a translational, transdiagnostic approach to understanding externalizing/depression comorbidity. This model should refine ways in which internalizing and externalizing disorders are studied, classified, and treated.

  20. Sex differences in succumbing to sexual temptations: a function of impulse or control?

    Science.gov (United States)

    Tidwell, Natasha D; Eastwick, Paul W

    2013-12-01

    Men succumb to sexual temptations (e.g., infidelity, mate poaching) more than women. Explanations for this effect vary; some researchers propose that men and women differ in sexual impulse strength, whereas others posit a difference in sexual self-control. These studies are the first to test such underlying mechanisms. In Study 1, participants reported on their impulses and intentional control exertion when they encountered a real-life tempting but forbidden potential partner. Study 2 required participants to perform a reaction-time task in which they accepted/rejected potential partners, and we used process dissociation to separate the effects of impulse and control. In both studies, men succumbed to the sexual temptations more than women, and this sex difference emerged because men experienced stronger impulses, not because they exerted less intentional control. Implications for the integration of evolutionary and self-regulatory perspectives on sex differences are discussed.

  1. Attentional and motor impulsivity interactively predict 'food addiction' in obese individuals.

    Science.gov (United States)

    Meule, Adrian; de Zwaan, Martina; Müller, Astrid

    2017-01-01

    Impulsivity is a multifaceted construct and constitutes a common risk factor for a range of behaviors associated with poor self-control (e.g., substance use or binge eating). The short form of the Barratt Impulsiveness Scale (BIS-15) measures impulsive behaviors related to attentional (inability to focus attention or concentrate), motor (acting without thinking), and non-planning (lack of future orientation or forethought) impulsivity. Eating-related measures appear to be particularly related to attentional and motor impulsivity and recent findings suggest that interactive effects between these two facets may play a role in eating- and weight-regulation. One-hundred thirty-three obese individuals presenting for bariatric surgery (77.4% female) completed the BIS-15 and the Yale Food Addiction Scale (YFAS) 2.0, which measures addiction-like eating based on the eleven symptoms of substance use disorder outlined in the fifth version of the Diagnostic and Statistical Manual of Mental Disorders. Sixty-three participants (47.4%) were classified as being 'food addicted'. Scores on attentional and motor impulsivity interactively predicted 'food addiction' status: higher attentional impulsivity was associated with a higher likelihood of receiving a YFAS 2.0 diagnosis only at high (+1 SD), but not at low (-1 SD) levels of motor impulsivity. Results support previous findings showing that non-planning impulsivity does not appear to play a role in eating-related self-regulation. Furthermore, this is the first study that shows interactive effects between different impulsivity facets when predicting 'food addiction' in obese individuals. Self-regulatory failure in eating-regulation (e.g., addiction-like overeating) may particularly emerge when both attentional and motor impulsivity levels are elevated. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Context influences decision-making in boys with attention-deficit/hyperactivity disorder: A comparison of traditional and novel choice-impulsivity paradigms.

    Science.gov (United States)

    Patros, Connor H G; Alderson, R Matt; Lea, Sarah E; Tarle, Stephanie J

    2017-02-01

    Attention-deficit/hyperactivity disorder (ADHD) is characterized by an impaired ability to maintain attention and/or hyperactivity/impulsivity. Impulsivity is frequently defined as the preference for small, immediate rewards over larger, delayed rewards, and has been associated with a variety of negative outcomes such as risky behavior and academic difficulty. Extant studies have uniformly utilized the traditional paradigm of presenting two response choices, which limits the generalization of findings to scenarios in which children/adolescents are faced with dichotomous decisions. The current study is the first to examine the effect of manipulating the number of available response options on impulsive decision-making in boys with and without ADHD. A total of 39 boys (ADHD = 16, typically developing [TD] = 23) aged 8-12 years completed a traditional two-choice impulsivity task and a novel five-choice impulsivity task to examine the effect of manipulating the number of choice responses (two vs five) on impulsive decision-making. A five-choice task was utilized as it presents a more continuous array of choice options when compared to the typical two-choice task, and is comparable given its methodological similarity to the two-choice task. Results suggested that boys with ADHD were significantly more impulsive than TD boys during the two-choice task, but not during the five-choice task. Collectively, these findings suggest that ADHD-related impulsivity is not ubiquitous, but rather dependent on variation in demands and/or context. Further, these findings highlight the importance of examining ADHD-related decision-making within the context of alternative paradigms, as the exclusive utilization of two-choice tasks may promote inaccurate conceptualizations of the disorder.

  3. Trichotillomania (hair pulling disorder), skin picking disorder, and stereotypic movement disorder: toward DSM-V.

    Science.gov (United States)

    Stein, Dan J; Grant, Jon E; Franklin, Martin E; Keuthen, Nancy; Lochner, Christine; Singer, Harvey S; Woods, Douglas W

    2010-06-01

    In DSM-IV-TR, trichotillomania (TTM) is classified as an impulse control disorder (not classified elsewhere), skin picking lacks its own diagnostic category (but might be diagnosed as an impulse control disorder not otherwise specified), and stereotypic movement disorder is classified as a disorder usually first diagnosed in infancy, childhood, or adolescence. ICD-10 classifies TTM as a habit and impulse disorder, and includes stereotyped movement disorders in a section on other behavioral and emotional disorders with onset usually occurring in childhood and adolescence. This article provides a focused review of nosological issues relevant to DSM-V, given recent empirical findings. This review presents a number of options and preliminary recommendations to be considered for DSM-V: (1) Although TTM fits optimally into a category of body-focused repetitive behavioral disorders, in a nosology comprised of relatively few major categories it fits best within a category of motoric obsessive-compulsive spectrum disorders, (2) available evidence does not support continuing to include (current) diagnostic criteria B and C for TTM in DSM-V, (3) the text for TTM should be updated to describe subtypes and forms of hair pulling, (4) there are persuasive reasons for referring to TTM as "hair pulling disorder (trichotillomania)," (5) diagnostic criteria for skin picking disorder should be included in DSM-V or in DSM-Vs Appendix of Criteria Sets Provided for Further Study, and (6) the diagnostic criteria for stereotypic movement disorder should be clarified and simplified, bringing them in line with those for hair pulling and skin picking disorder. (c) 2010 Wiley-Liss, Inc.

  4. Integrative Understanding of Familial Impulsivity, Early Adversity and Suicide Risk

    OpenAIRE

    Lima, Isabela M. M.; Malloy-Diniz, Leandro F.; de Miranda, Débora M.; Da Silva, Antônio G.; Neves, Fernando S.; Johnson, Sheri L.

    2017-01-01

    Introduction: Impulsivity is a core characteristic of bipolar disorder and it was observed as elevated in individuals with the disorder and in their relatives. Both impulsivity and history of maltreatment are risk factors for suicide attempts, however, these two key variables may not be independent, given the fact that parental impulsivity and associated social context could increase the risk of child maltreatment. In this study it was examined the association between the impulsivity of relat...

  5. Tridimensional Personality Questionnaire data on alcoholic violent offenders: specific connections to severe impulsive cluster B personality disorders and violent criminality.

    Science.gov (United States)

    Tikkanen, Roope; Holi, Matti; Lindberg, Nina; Virkkunen, Matti

    2007-07-30

    The validity of traditional categorical personality disorder diagnoses is currently re-evaluated from a continuous perspective, and the evolving DSM-V classification may describe personality disorders dimensionally. The utility of dimensional personality assessment, however, is unclear in violent offenders with severe personality pathology. The temperament structure of 114 alcoholic violent offenders with antisocial personality disorder (ASPD) was compared to 84 offenders without ASPD, and 170 healthy controls. Inclusion occurred during a court-ordered mental examination preceded by homicide, assault, battery, rape or arson. Participants underwent assessment of temperament with the Tridimensional Personality Questionnaire (TPQ) and were diagnosed with DSM-III-R criteria. The typical temperament profile in violent offender having ASPD comprised high novelty seeking, high harm avoidance, and low reward dependence. A 21% minority scored low in trait harm avoidance. Results, including the polarized harm avoidance dimension, are in accordance with Cloninger's hypothesis of dimensional description of ASPD. The low harm avoidance offenders committed less impulsive violence than high harm avoidance offenders. High harm avoidance was associated with comorbid antisocial personality disorder and borderline personality disorder. Results indicate that the DSM based ASPD diagnosis in alcoholic violent offenders associates with impulsiveness and high novelty seeking but comprises two different types of ASPD associated with distinct second-order traits that possibly explain differences in type of violent criminality. Low harm avoidance offenders have many traits in common with high scorers on the Hare Psychopathy Checklist-Revised (PCL-R). Results link high harm avoidance with broad personality pathology and argue for the usefulness of self-report questionnaires in clinical praxis.

  6. Oppositional Defiant Disorder (ODD)

    Science.gov (United States)

    ... Antisocial behavior Impulse control problems Substance use disorder Suicide Many children and teens with ODD also have other mental health disorders, such as: Attention-deficit/hyperactivity disorder (ADHD) Conduct disorder Depression Anxiety Learning and communication disorders Treating these other ...

  7. Male anorexia and bulimia nervosa: Disorder symptoms and impulsive behaviour during hospital treatment and one year follow-up period.

    Science.gov (United States)

    Sernec, Karin; Mrevlje, Gorazd V; Čarapič, Jadranka; Weber, Urška; Zalar, Bojan

    2015-09-01

    The study aimed to evaluate treatment efficacy in male patients with anorexia (AN) and bulimia nervosa (BN) treated at the Eating Disorder Unit, University Psychiatric Clinic Ljubljana, Slovenia (EDU UPCL), using longitudinal assessments of eating disorder (ED) symptoms and selected impulsive behaviours highly correlated with these entities from hospital admission till twelve months after. 35 male AN and 35 male BN patients were included. Participants were aged 17 or more and somatically stable with the BMI>12 kg/m(2). Patients with psychiatric comorbidity, mental disorder due to a general medical condition, or serious somatic or neurological disease were excluded. Intensity of ED symptoms and presence of selected impulsive behaviours were evaluated at hospital admission and discharge, and three, six and twelve months after, using an internal Eating Disorder Unit Questionnaire. For statistical analysis multivariate analysis of variance was used. Throughout the research period the appropriate changes in BMI were observed in both patient groups. In both, AN and BN patient groups, the evaluation of longitudinal differences regarding the intensity of all ED symptoms and the presence of studied impulsive behaviours showed a significant decline at discharge and all subsequent assessments compared to the results obtained upon admission to the hospital. The re-hospitalization rates of patients with AN and BN in the first year after discharge from the hospital were 3.84% vs. 3.7% respectively. In male patients with AN and BN treated at the EDU UPCL, ED symptoms, BMI, and studied impulsive behaviours show a substantial improvement during hospital treatment. These changes seem to be long lasting, still being effective through one-year post-hospitalization follow-up.

  8. Impulsive and compulsive behaviors in Parkinson's disease.

    Science.gov (United States)

    Evans, Andrew H; Strafella, Antonio P; Weintraub, Daniel; Stacy, Mark

    2009-08-15

    Antiparkinson therapy can be the primary cause of a range of nonmotor symptoms that include a set of complex disinhibitory psychomotor pathologies and are linked by their repetitive, reward or incentive-based natures. These behaviors relate to aberrant or excessive dopamine receptor stimulation and encompass impulse control disorders (ICDs), punding, and the dopamine dysregulation syndrome (DDS). Common ICDs include pathological gambling, hypersexuality, compulsive eating, and compulsive buying. This review focuses on the phenomenology, epidemiology, and methods to identify and rate these disorders. The management of dopaminergic drug-related compulsive behaviors is discussed in the light of the current understanding of the neurobiological substrate of these disorders. 2009 Movement Disorder Society.

  9. Control of impulsive renewal systems: Application to direct design in networked control

    NARCIS (Netherlands)

    Guerreiro Tome Antunes, D.J.; Hespanha, J.P.; Silvestre, C.J.

    2009-01-01

    We consider the control of impulsive systems with independent and identically distributed intervals between jumps. The control action and output measurement are assumed to take place only at jump times. We give necessary and sufficient conditions, in the form of LMIs, for mean square stabilizability

  10. Instructional and improvisational models of music therapy with adolescents who have attention deficit hyperactivity disorder (ADHD): a comparison of the effects on motor impulsivity.

    Science.gov (United States)

    Rickson, Daphne J

    2006-01-01

    This study compared the impact of instructional and improvisational music therapy approaches on the level of motor impulsivity displayed by adolescent boys (n = 13) who have Attention Deficit Hyperactivity Disorder (ADHD). A combination of a multiple contrasting treatment and an experimental control group design was used. No statistical difference was found between the impact of the contrasting approaches as measured by a Synchronised Tapping Task (STT) (Humphrey, 2003) and the parent and teacher versions of Conners' Rating Scales (Conners, 1997) Restless-Impulsive (R-I) and Hyperactive-Impulsive (H-I) subscales. However, while no firm conclusions can be drawn, there are indications that the instructional approach may have contributed to a reduction of impulsive and restless behaviors in the classroom. Further, over the period of the study, both music therapy treatment groups significantly improved accuracy on the STT, and teachers reported a significant reduction in Conners' DSM-IV Total and Global Index subscale scores. These findings tentatively suggest that music therapy may contribute to a reduction in a range of ADHD symptoms in the classroom, and that increasing accuracy on the STT could be related to improvement in a range of developmental areas-not specifically motor impulsivity.

  11. Is there an empirical link between impulsivity and suicidality in bipolar disorders? A review of the current literature and the potential psychological implications of the relationship.

    Science.gov (United States)

    Watkins, Hannah B; Meyer, Thomas D

    2013-08-01

    Suicide is highly prevalent among individuals with bipolar disorder and understanding the factors that increase risk for suicide may help to develop targeted interventions to prevent attempts. Impulsivity is thought to be an influential factor associated with suicidality and is also discussed as a key construct of bipolar disorder. The aim of this paper was to systematically review the current evidence to examine the association between impulsivity and suicidality in bipolar disorder. PsycInfo, Medline, and Web of Knowledge databases were searched for articles published up until March 2012. Papers were included if they assessed an adult sample of individuals with bipolar disorders, focused on suicidality (ideation with intent to die, suicide attempts, or completion), and used a validated measure to determine impulsivity. Sixteen papers were identified. Contrary to widespread belief, we found (i) a very inconsistent picture of results including positive, negative, and insignificant associations between impulsivity and suicidality; and (ii) some studies do not take into account important aspects such as state-trait or measurement issues. The link between suicidality and impulsivity is less straightforward than often assumed. Drawing clear conclusions about the association is hampered by factors such as inconsistencies in defining suicidality, measuring impulsivity, and differentiating between impulsivity as a personality trait and impulsivity as a state (e.g., a consequence of substance use or premeditation of the attempt). We suggest that the association is less direct and that psychological models (e.g., Joiner's theory of suicidality) can help foster a more in-depth understanding regarding the relationship. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Chaos and its control in an impulsive differential system

    International Nuclear Information System (INIS)

    Jiang Guirong; Lu Qishao; Qian Linning

    2007-01-01

    In this paper, the existence of chaos and its control in an autonomous impulsive differential system are discussed both theoretically and numerically. The existence of a snap-back repeller, as well as the chaos in the sense of Li-Yorke, is proved based on the qualitative analysis using the Poincare map and the Lambert W-function. Moreover, the existence of the period-3 periodic window embedded in the chaotic region is also demonstrated. An algorithm of chaos control to stabilize the unstable periodic solutions is proposed. Detailed numerical results of chaotic attractors and stabilization of unstable periodic orbits by the impulsive effects, which are illustrated by an example, are in good agreement with the theoretical analysis

  13. Impulsivity and compulsive buying are associated in a non-clinical sample: an evidence for the compulsivity-impulsivity continuum?

    OpenAIRE

    Paula, Jonas J. de; Costa, Danielle de S.; Oliveira, Flavianne; Alves, Joana O.; Passos, Lídia R.; Malloy-Diniz, Leandro F.

    2015-01-01

    Objective:Compulsive buying is controversial in clinical psychiatry. Although it is defined as an obsessive-compulsive disorder, other personality aspects besides compulsivity are related to compulsive buying. Recent studies suggest that compulsivity and impulsivity might represent a continuum, with several psychiatric disorders lying between these two extremes. In this sense, and following the perspective of dimensional psychiatry, symptoms of impulsivity and compulsivity should correlate ev...

  14. Executive functioning and risk-taking behavior in Parkinson's disease patients with impulse control disorders.

    Science.gov (United States)

    Pineau, Fanny; Roze, Emmanuel; Lacomblez, Lucette; Bonnet, Anne-Marie; Vidailhet, Marie; Czernecki, Virginie; Corvol, Jean-Christophe

    2016-06-01

    Impulse control disorders (ICD) are common in Parkinson's disease (PD) and are associated with dopaminergic medication. The purpose of this study was to investigate executive function and risk-taking behavior in PD patients with ICD. 17 PD patients with ICD (ICD-PD) were compared to 20 PD patients without ICD (CTRL-PD) using neuropsychological and experimental tasks. Executive functions were assessed using standard executive testing (Conner's Performance Test, Modified Wisconsin Card Sorting Test, Trail Making Test and phonological verbal fluency). Subjects were also submitted to an experimental gambling task consisted of three decks of money cards: neutral deck (equal opportunity for gains as losses), winning deck (small amount of money with a positive balance) and loser deck (high amount of money with a negative balance), evaluating risk-taking behavior (number of cards picked in each deck) and valuation of the reward (subjective appreciation of the value of each deck). There was no significant difference in executive functioning between groups. Both groups selected more cards in the losing deck (high amount of money) as compared to the neutral deck (Mann-Whitney test, ICD-PD, p = 0.02; CTRL-PD, p = 0.003) and to the winning deck (Mann-Whitney test, ICD-PD p = 0.0001; CTRL-PD p = 0.003), suggesting an increased risk-taking behavior. Interestingly, we found that ICD-PD patients estimated the value of decks differently from CTRL-PD patients, taking into account mainly the positive reinforced value of the decks (Mann-Whitney test, p = 0.04). This study showed that executive pattern and risk-taking behavior are similar between ICD-PD and CTRL-PD patients. However, ICD-PD patients showed a specific deficit of the subjective estimation of the reward. Links between this deficit and metacognitive skills are discussed.

  15. The relationship between impulsive choice and impulsive action: a cross-species translational study.

    Directory of Open Access Journals (Sweden)

    Nienke Broos

    Full Text Available Maladaptive impulsivity is a core symptom in various psychiatric disorders. However, there is only limited evidence available on whether different measures of impulsivity represent largely unrelated aspects or a unitary construct. In a cross-species translational study, thirty rats were trained in impulsive choice (delayed reward task and impulsive action (five-choice serial reaction time task paradigms. The correlation between those measures was assessed during baseline performance and after pharmacological manipulations with the psychostimulant amphetamine and the norepinephrine reuptake inhibitor atomoxetine. In parallel, to validate the animal data, 101 human subjects performed analogous measures of impulsive choice (delay discounting task, DDT and impulsive action (immediate and delayed memory task, IMT/DMT. Moreover, all subjects completed the Stop Signal Task (SST, as an additional measure of impulsive action and filled out the Barratt impulsiveness scale (BIS-11. Correlations between DDT and IMT/DMT were determined and a principal component analysis was performed on all human measures of impulsivity. In both rats and humans measures of impulsive choice and impulsive action did not correlate. In rats the within-subject pharmacological effects of amphetamine and atomoxetine did not correlate between tasks, suggesting distinct underlying neural correlates. Furthermore, in humans, principal component analysis identified three independent factors: (1 self-reported impulsivity (BIS-11; (2 impulsive action (IMT/DMT and SST; (3 impulsive choice (DDT. This is the first study directly comparing aspects of impulsivity using a cross-species translational approach. The present data reveal the non-unitary nature of impulsivity on a behavioral and pharmacological level. Collectively, this warrants a stronger focus on the relative contribution of distinct forms of impulsivity in psychopathology.

  16. Low plasma eicosapentaenoic acid levels are associated with elevated trait aggression and impulsivity in major depressive disorder with a history of comorbid substance use disorder.

    Science.gov (United States)

    Beier, Anne Mette; Lauritzen, Lotte; Galfalvy, Hanga C; Cooper, Thomas B; Oquendo, Maria A; Grunebaum, Michael F; Mann, J John; Sublette, M Elizabeth

    2014-10-01

    Major depressive disorder (MDD) is associated with low levels of omega-3 polyunsaturated fatty acids (PUFAs), holding promise for new perspectives on disease etiology and treatment targets. As aggressive and impulsive behaviors are associated with low omega-3 PUFA levels in some clinical contexts, we investigated plasma PUFA relationships with trait aggression and impulsivity in patients with MDD. Medication-free MDD patients (n = 48) and healthy volunteers (HV, n = 35) were assessed with the Brown-Goodwin Aggression Inventory. A subset (MDD, n = 39; HV, n = 33) completed the Barratt Impulsiveness Scale. Plasma PUFAs eicosapentaenoic acid (EPA, 20:5n-3), docosahexaenoic acid (DHA, 22:6n-3), and arachidonic acid (AA, 20:4n-6) were quantified and ln-transformed to mitigate distributional skew. Ln-transformed PUFA (lnPUFA) levels were predictors in regression models, with aggression or impulsivity scores as outcomes, and cofactors of sex and diagnostic status (MDD with or without a history of substance use disorder [SUD], or HV). Interactions were tested between relevant PUFAs and diagnostic status. Additional analyses explored possible confounds of depression severity, self-reported childhood abuse history, and, in MDD patients, suicide attempt history. Among PUFA, lnEPA but not lnDHA predicted aggression (F1,76 = 12.493, p = 0.001), and impulsivity (F1,65 = 5.598, p = 0.021), with interactions between lnEPA and history of SUD for both aggression (F1,76 = 7.941, p = 0.001) and impulsivity (F1,65 = 3.485, p = 0.037). Results remained significant when adjusted for childhood abuse, depression severity, or history of suicide attempt. In conclusion, low EPA levels were associated with aggression and impulsivity only in patients with MDD and comorbid SUD, even though in most cases SUD was in full sustained remission. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. The dynamics of a Beddington-type system with impulsive control strategy

    International Nuclear Information System (INIS)

    Li Zhenqing; Wang Weiming; Wang Hailing

    2006-01-01

    In this paper, by using the theories and methods of ecology and ordinary differential equation, a prey-predator system with Beddington-type functional response and impulsive control strategy is established. Conditions for the system to be extinct are given by using the theories of impulsive equation and small amplitude perturbation skills. It is proved that the system is permanent via the method of comparison involving multiple Liapunov functions. Furthermore, by using the method of numerical simulation, the influence of the impulsive control strategy on the inherent oscillation are investigated, which shows rich dynamics, such as period doubling bifurcation, crises, symmetry-breaking pitchfork bifurcations, chaotic bands, quasi-periodic oscillation, narrow periodic window, wide periodic window, period-halving bifurcation, etc. That will be useful for study of the dynamic complexity of ecosystems

  18. A Novel Optimal Control Method for Impulsive-Correction Projectile Based on Particle Swarm Optimization

    Directory of Open Access Journals (Sweden)

    Ruisheng Sun

    2016-01-01

    Full Text Available This paper presents a new parametric optimization approach based on a modified particle swarm optimization (PSO to design a class of impulsive-correction projectiles with discrete, flexible-time interval, and finite-energy control. In terms of optimal control theory, the task is described as the formulation of minimum working number of impulses and minimum control error, which involves reference model linearization, boundary conditions, and discontinuous objective function. These result in difficulties in finding the global optimum solution by directly utilizing any other optimization approaches, for example, Hp-adaptive pseudospectral method. Consequently, PSO mechanism is employed for optimal setting of impulsive control by considering the time intervals between two neighboring lateral impulses as design variables, which makes the briefness of the optimization process. A modification on basic PSO algorithm is developed to improve the convergence speed of this optimization through linearly decreasing the inertial weight. In addition, a suboptimal control and guidance law based on PSO technique are put forward for the real-time consideration of the online design in practice. Finally, a simulation case coupled with a nonlinear flight dynamic model is applied to validate the modified PSO control algorithm. The results of comparative study illustrate that the proposed optimal control algorithm has a good performance in obtaining the optimal control efficiently and accurately and provides a reference approach to handling such impulsive-correction problem.

  19. Emotional sensitivity, emotion regulation and impulsivity in borderline personality disorder: a critical review of fMRI studies.

    Science.gov (United States)

    van Zutphen, Linda; Siep, Nicolette; Jacob, Gitta A; Goebel, Rainer; Arntz, Arnoud

    2015-04-01

    Emotional sensitivity, emotion regulation and impulsivity are fundamental topics in research of borderline personality disorder (BPD). Studies using fMRI examining the neural correlates concerning these topics is growing and has just begun understanding the underlying neural correlates in BPD. However, there are strong similarities but also important differences in results of different studies. It is therefore important to know in more detail what these differences are and how we should interpret these. In present review a critical light is shed on the fMRI studies examining emotional sensitivity, emotion regulation and impulsivity in BPD patients. First an outline of the methodology and the results of the studies will be given. Thereafter important issues that remained unanswered and topics to improve future research are discussed. Future research should take into account the limited power of previous studies and focus more on BPD specificity with regard to time course responses, different regulation strategies, manipulation of self-regulation, medication use, a wider range of stimuli, gender effects and the inclusion of a clinical control group. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. On the Impulsive Synchronization Control for a Class of Chaotic Systems

    Directory of Open Access Journals (Sweden)

    Bo Wang

    2014-01-01

    Full Text Available The problem on chaos synchronization for a class of chaotic system is addressed. Based on impulsive control theory and by constructing a novel Lyapunov functional, new impulsive synchronization strategies are presented and possess more practical application value. Finally some typical numerical simulation examples are included to demonstrate the effectiveness of the theoretical results.

  1. Impulsive Controller Design for Complex Nonlinear Singular Networked Systems with Packet Dropouts

    Directory of Open Access Journals (Sweden)

    Xian-Lin Zhao

    2013-01-01

    Full Text Available Globally exponential stability of Complex (with coupling Nonlinear Singular Impulsive Networked Control Systems (CNSINCS with packet dropouts and time-delay is investigated. Firstly, the mathematic model of CNSINCS is established. Then, by employing the method of Lyapunov functional, exponential stability criteria are obtained and the impulsive controller design method is given. Finally, some simulation results are provided to demonstrate the effectiveness of the proposed method.

  2. Mood instability and impulsivity as trait predictors of suicidal thoughts.

    Science.gov (United States)

    Peters, Evyn M; Balbuena, Lloyd; Marwaha, Steven; Baetz, Marilyn; Bowen, Rudy

    2016-12-01

    Impulsivity, the tendency to act quickly without adequate planning or concern for consequences, is a commonly cited risk factor for suicidal thoughts and behaviour. There are many definitions of impulsivity and how it relates to suicidality is not well understood. Mood instability, which describes frequent fluctuations of mood over time, is a concept related to impulsivity that may help explain this relationship. The purpose of this study was to determine whether impulsivity could predict suicidal thoughts after controlling for mood instability. This study utilized longitudinal data from the 2000 Adult Psychiatric Morbidity Survey (N = 2,406). There was a time interval of 18 months between the two waves of the study. Trait impulsivity and mood instability were measured with the Structured Clinical Interview for DSM-IV Axis II Personality Disorders. Logistic regression analyses were used to evaluate baseline impulsivity and mood instability as predictors of future suicidal thoughts. Impulsivity significantly predicted the presence of suicidal thoughts, but this effect became non-significant with mood instability included in the same model. Impulsivity may be a redundant concept when predicting future suicidal thoughts if mood instability is considered. The significance is that research and therapy focusing on mood instability along with impulsivity may be useful in treating the suicidal patient. Mood instability and impulsivity both predict future suicidal thoughts. Impulsivity does not predict suicidal thoughts after controlling for mood instability. Assessing and treating mood instability could be important aspects of suicide prevention and risk management. © 2015 The British Psychological Society.

  3. Tridimensional Personality Questionnaire data on alcoholic violent offenders: specific connections to severe impulsive cluster B personality disorders and violent criminality

    Directory of Open Access Journals (Sweden)

    Lindberg Nina

    2007-07-01

    Full Text Available Abstract Background The validity of traditional categorical personality disorder diagnoses is currently re-evaluated from a continuous perspective, and the evolving DSM-V classification may describe personality disorders dimensionally. The utility of dimensional personality assessment, however, is unclear in violent offenders with severe personality pathology. Methods The temperament structure of 114 alcoholic violent offenders with antisocial personality disorder (ASPD was compared to 84 offenders without ASPD, and 170 healthy controls. Inclusion occurred during a court-ordered mental examination preceded by homicide, assault, battery, rape or arson. Participants underwent assessment of temperament with the Tridimensional Personality Questionnaire (TPQ and were diagnosed with DSM-III-R criteria. Results The typical temperament profile in violent offender having ASPD comprised high novelty seeking, high harm avoidance, and low reward dependence. A 21% minority scored low in trait harm avoidance. Results, including the polarized harm avoidance dimension, are in accordance with Cloninger's hypothesis of dimensional description of ASPD. The low harm avoidance offenders committed less impulsive violence than high harm avoidance offenders. High harm avoidance was associated with comorbid antisocial personality disorder and borderline personality disorder. Conclusion Results indicate that the DSM based ASPD diagnosis in alcoholic violent offenders associates with impulsiveness and high novelty seeking but comprises two different types of ASPD associated with distinct second-order traits that possibly explain differences in type of violent criminality. Low harm avoidance offenders have many traits in common with high scorers on the Hare Psychopathy Checklist-Revised (PCL-R. Results link high harm avoidance with broad personality pathology and argue for the usefulness of self-report questionnaires in clinical praxis.

  4. Case Control Study of Impulsivity, Aggression, Pesticide Exposure and Suicide Attempts Using Pesticides among Farmers.

    Science.gov (United States)

    Lyu, Chun Ping; Pei, Jian Ru; Beseler, L Cheryl; Li, Yu Ling; Li, Jian Hui; Ren, Ming; Stallones, Lorann; Ren, Shu Ping

    2018-03-01

    A case-control study was conducted to investigate associations between organophosphate pesticide (OP) exposure, aggression, impulsivity, and attempted suicide. Questionnaires were used to collect information; impulsivity and aggression were measured by the Barratt Impulsivity Scale (BIS) and the Aggression Inventory (AI). A greater number of OP symptoms was associated with an increased odds of a suicide attempt after adjusting for marital status and income (OR = 1.45; CI 1.14-1.86). Attempted suicide was significantly associated with high impulsivity scores (means: 72.4 vs. 60.6, P controls and scored higher on scales of impulsivity and aggression. Copyright © 2018 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

  5. Losing control

    DEFF Research Database (Denmark)

    Leppink, Eric; Odlaug, Brian Lawrence; Lust, Katherine

    2014-01-01

    picking disorder). CONCLUSIONS: Assaultive behavior appears fairly common among college students and is associated with symptoms of depression and impulse control disorders. Significant distress and diminished behavioral control suggest that assaultive behaviors may often be associated with significant......OBJECTIVE: Assaultive behaviors are common among young people and have been associated with a range of other unhealthy, impulsive behaviors such as substance use and problem gambling. This study sought to determine the predictive ability of single assaultive incidents for impulse control disorders......, an association that has yet to be examined, especially in young adults. METHODS: The authors conducted a university-wide email survey in the spring of 2011 on 6000 university students. The survey examined assaultive behavior and associated mental health variables (using a clinically validated screening...

  6. A European multicentre survey of impulse control behaviours in Parkinson's disease patients treated with short- and long-acting dopamine agonists.

    Science.gov (United States)

    Rizos, A; Sauerbier, A; Antonini, A; Weintraub, D; Martinez-Martin, P; Kessel, B; Henriksen, T; Falup-Pecurariu, C; Silverdale, M; Durner, G; Røkenes Karlsen, K; Grilo, M; Odin, P; Chaudhuri, K Ray

    2016-08-01

    Impulse control disorders (ICDs) in Parkinson's disease (PD) are associated primarily with dopamine agonist (DA) use. Comparative surveys of clinical occurrence of impulse control behaviours on longer acting/transdermal DA therapy across age ranges are lacking. The aim of this study was to assess the occurrence of ICDs in PD patients across several European centres treated with short- or long-acting [ropinirole (ROP); pramipexole (PPX)] and transdermal [rotigotine skin patch (RTG)] DAs, based on clinical survey as part of routine clinical care. A survey based on medical records and clinical interviews of patients initiating or initiated on DA treatment (both short- and long-acting, and transdermal) across a broad range of disease stages and age groups was performed. Four hundred and twenty-five cases were included [mean age 68.3 years (range 37-90), mean duration of disease 7.5 years (range 0-37)]. ICD frequencies (as assessed by clinical interview) were significantly lower with RTG (4.9%; P controlling for possible confounding factors. © 2016 EAN.

  7. An investigation of two dimensions of impulsivity as predictors of loss-of-control eating severity and frequency.

    Science.gov (United States)

    Espel, Hallie M; Muratore, Alexandra F; Lowe, Michael R

    2017-10-01

    Loss-of-control (LOC) eating episodes represent one form of dysregulated eating common to full- and sub-threshold eating disorders. Extensive evidence suggests that impulsivity, particularly in the context of negative affect and/or depression, may play an important etiological role in the development and maintenance of LOC eating. However, most prior studies have considered LOC eating as a dichotomous rather than dimensional construct, and few studies have considered the interaction of multiple dimensions of impulsivity while also accounting for the role of depressive symptoms. The present study examined the independent and interacting effects of two facets of impulsivity-response inhibition and negative urgency-on LOC eating episode severity and frequency among college women (N = 102). Depressive symptom severity was included as a covariate. Results indicated that greater negative urgency was associated with greater LOC severity; this effect was moderated by response inhibition, such that the effect of urgency was particularly pronounced for individuals with higher response inhibition capacity. Negative urgency was the only significant predictor of LOC frequency. Depression had no significant effect on either LOC severity or frequency (ps ≥ 0.16). Results support the importance of considering multiple facets of impulsivity in predicting LOC eating behavior, and further indicate that factors influencing subjective severity and frequency of LOC may be distinct. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Emotional sensitivity, emotion regulation and impulsivity in borderline personality disorder : a critical review of fMRI studies

    NARCIS (Netherlands)

    van Zutphen, Linda; Siep, Nicolette; Jacob, Gitta A; Goebel, R.; Arntz, Arnoud

    Emotional sensitivity, emotion regulation and impulsivity are fundamental topics in research of borderline personality disorder (BPD). Studies using fMRI examining the neural correlates concerning these topics is growing and has just begun understanding the underlying neural correlates in BPD.

  9. Facets of impulsivity in the relationship between antisocial personality and abstinence.

    Science.gov (United States)

    Sargeant, Marsha N; Bornovalova, Marina A; Trotman, Adria J-M; Fishman, Shira; Lejuez, Carl W

    2012-03-01

    Most individuals who enter drug treatment programs are unable to maintain long-term abstinence. This problem is especially relevant for those presenting with Antisocial Personality Disorder (ASPD). In examining potential mechanisms underlying the relationship between ASPD and abstinence, one factor that may be especially useful is the personality variable of impulsivity. Thus, the current study examined ASPD status in relation to longest abstinence attempt among 117 substance use treatment-seeking individuals, considering the mediating role of five facets of impulsivity: urgency, perseverance, premeditation, control, and delay discounting. Results indicated that individuals with ASPD evidenced shorter previous abstinence attempts and lower levels of perseverance and control than those without ASPD. Further, lower levels of control were associated with shorter abstinence attempts. Finally, control mediated the relationship between ASPD and longest quit attempt. These results suggest the potential value of multiple facets of impulsivity in efforts to understand relapse and subsequent treatment development efforts. Copyright © 2011 Elsevier Ltd. All rights reserved.

  10. Impulsive Synchronization and Adaptive-Impulsive Synchronization of a Novel Financial Hyperchaotic System

    Directory of Open Access Journals (Sweden)

    Xiuli Chai

    2013-01-01

    Full Text Available The impulsive synchronization and adaptive-impulsive synchronization of a novel financial hyperchaotic system are investigated. Based on comparing principle for impulsive functional differential equations, several sufficient conditions for impulsive synchronization are derived, and the upper bounds of impulsive interval for stable synchronization are estimated. Furthermore, a nonlinear adaptive-impulsive control scheme is designed to synchronize the financial system using invariant principle of impulsive dynamical systems. Moreover, corresponding numerical simulations are presented to illustrate the effectiveness and feasibility of the proposed methods.

  11. State impulsive control strategies for a two-languages competitive model with bilingualism and interlinguistic similarity

    Science.gov (United States)

    Nie, Lin-Fei; Teng, Zhi-Dong; Nieto, Juan J.; Jung, Il Hyo

    2015-07-01

    For reasons of preserving endangered languages, we propose, in this paper, a novel two-languages competitive model with bilingualism and interlinguistic similarity, where state-dependent impulsive control strategies are introduced. The novel control model includes two control threshold values, which are different from the previous state-dependent impulsive differential equations. By using qualitative analysis method, we obtain that the control model exhibits two stable positive order-1 periodic solutions under some general conditions. Moreover, numerical simulations clearly illustrate the main theoretical results and feasibility of state-dependent impulsive control strategies. Meanwhile numerical simulations also show that state-dependent impulsive control strategy can be applied to other general two-languages competitive model and obtain the desired result. The results indicate that the fractions of two competitive languages can be kept within a reasonable level under almost any circumstances. Theoretical basis for finding a new control measure to protect the endangered language is offered.

  12. Low plasma eicosapentaenoic acid levels are associated with elevated trait aggression and impulsivity in major depressive disorder with a history of comorbid substance use disorder

    DEFF Research Database (Denmark)

    Beier, Anne Mette; Lauritzen, Lotte; Galfalvy, Hanga C

    2014-01-01

    -reported childhood abuse history, and, in MDD patients, suicide attempt history. Among PUFA, lnEPA but not lnDHA predicted aggression (F1,76 = 12.493, p = 0.001), and impulsivity (F1,65 = 5.598, p = 0.021), with interactions between lnEPA and history of SUD for both aggression (F1,76 = 7.941, p = 0.......001) and impulsivity (F1,65 = 3.485, p = 0.037). Results remained significant when adjusted for childhood abuse, depression severity, or history of suicide attempt. In conclusion, low EPA levels were associated with aggression and impulsivity only in patients with MDD and comorbid SUD, even though in most cases SUD......Major depressive disorder (MDD) is associated with low levels of omega-3 polyunsaturated fatty acids (PUFAs), holding promise for new perspectives on disease etiology and treatment targets. As aggressive and impulsive behaviors are associated with low omega-3 PUFA levels in some clinical contexts...

  13. Self-reported impulsivity, but not behavioral approach or inhibition, mediates the relationship between stress and self-control.

    Science.gov (United States)

    Hamilton, Kristen R; Sinha, Rajita; Potenza, Marc N

    2014-11-01

    Stress has been associated with poor self-control. Individual differences in impulsivity and other behavioral tendencies may influence the relationship of stress with self-control, although this possibility has not been examined to date. The present research investigated whether cumulative stress is associated with poor self-control, and whether this relationship is mediated by impulsivity, behavioral approach, and behavioral inhibition in men and women. A community sample of 566 adults (319 women and 247 men) was assessed on the Cumulative Adversity Interview, Brief Self-control Scale, Barratt Impulsivity Scale, and Behavioral Activation System and Behavioral Inhibition System Scale (BIS/BAS). Data were analyzed using regression and bootstrapping techniques. In the total sample, the effects of cumulative stress on self-control were mediated by impulsivity. Neither behavioral inhibition nor behavioral approach mediated the association between cumulative stress and self-control in the total sample. Results were similar when men and women were considered separately, with impulsivity, but not behavioral inhibition or approach, mediating the association between cumulative stress and self-control. Impulsive individuals might benefit preferentially from interventions focusing on stress management and strategies for improving self-control. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Dynamic analysis of the ethanol fermentation with the impulsive state feedback control

    International Nuclear Information System (INIS)

    Zhao, Zhong; Kong, Yinchang; Chen, Ying

    2016-01-01

    Highlights: • Ethanol fermentation model with the impulsive state feedback control is proposed. • Existence and stability of the order-1 or order-2 periodic solution are investigated. • The complete expression of the order-1 periodic solution is obtained. • Fermentation process can be effectively controlled by monitoring the impulsive period. - Abstract: To keep a sustainable and steady output of ethanol, ethanol fermentation in a bio-reactor with impulsive state feedback control is formulated. The sufficient conditions for existences of order-1 periodic solution and order-2 periodic solution are obtained by using the properties of the periodic solution. The results imply that ethanol fermentation tends to an order-1 periodic solution or order-2 periodic solution. At the same time, we also give the complete expression of the period of the positive period-1 solution. Finally, discussions and numerical simulations are given.

  15. Cigarette cravings, impulsivity and the brain

    Directory of Open Access Journals (Sweden)

    Stéphane ePotvin

    2015-09-01

    Full Text Available Craving is a core feature of tobacco use disorder as well as a significant predictor of smoking relapse. Studies have shown that appetitive smoking-related stimuli (e.g. someone smoking trigger significant cravings in smokers which impedes their self-control capacities and promotes drug seeking behavior. In this review, we begin by an overview of functional magnetic resonance imaging (fMRI studies investigating the neural correlates of smokers to appetitive smoking cues. The literature reveals a complex and vastly distributed neuronal network underlying smokers’ craving response that recruits regions involved in self-referential processing, panning/regulatory processes, emotional responding, attentional biases, and automatic conducts. We then selectively review important factors contributing to the heterogeneity of results that significantly limit the implications of these findings, namely between- (abstinence, smoking expectancies and self-regulation and within-studies factors (severity of smoking dependence, sex-differences, motivation to quit and genetic factors. Remarkably, we found that little to no attention has been devoted to examine the influence of personality traits on the neural correlates of cigarette cravings in fMRI studies. Impulsivity has been linked with craving and relapse in substance and tobacco use, which prompted our research team to examine the influence of impulsivity on cigarette cravings in an fMRI study. We found that the influence of impulsivity on cigarette cravings was mediated by fronto-cingular mechanisms. Given the high prevalence of cigarette smoking in several psychiatric disorders that are characterized by significant levels of impulsivity, we conclude by identifying psychiatric patients as a target population whose tobacco smoking habits deserve further behavioral and neuro-imaging investigation.

  16. The moderating effects of impulsivity on Chinese rural young suicide.

    Science.gov (United States)

    Zhang, Jie; Lin, Lin

    2014-06-01

    As only about 50% of Chinese suicides have mental disorders, nonpsychiatric factors such as social environment and personality may account for the variance that is not explained by mental problems. We try to explore the effects of impulsivity on Chinese suicides and the role impulsivity plays in the relationship between negative life events (NLEs) and suicidal behavior. A total of 392 suicide cases (178 female and 214 male, aged 15-34 years) and 416 community controls (202 males and 214 females) of the same age range were sampled in China. The case-control data were obtained using psychological autopsy method with structured and semistructured instruments. Impulsivity was an important predictor of Chinese rural young suicides and it was a moderator between NLEs and suicide. Findings of the study may be translated into practical measures in suicide prevention in China as well as elsewhere in the world. © 2013 Wiley Periodicals, Inc.

  17. Endogenous opioid blockade and impulsive responding in alcoholics and healthy controls.

    Science.gov (United States)

    Mitchell, Jennifer M; Tavares, Venessa C; Fields, Howard L; D'Esposito, Mark; Boettiger, Charlotte A

    2007-02-01

    The opioid receptor antagonist naltrexone (NTX) is one of few approved treatments for alcoholism, yet the mechanism by which it reduces drinking remains unclear. In rats, NTX reduces morphine-induced impulsive choice bias; however, nothing is known about the drug's effect on discrete aspects of impulsive behavior in humans, such as decision-making and inhibitory control. Here, we used a modified delay discounting procedure to investigate whether NTX improves decision-making or inhibitory control in humans. We measured the effect of acute NTX (50 mg) on choice between smaller sooner (SS) and larger later monetary rewards and on response errors (motor mismatch) in a high conflict condition in a group of abstinent alcoholics (AA) and healthy control subjects (CS). We previously reported that AA selected the SS option significantly more often than did CS in this paradigm. If the choice bias of AA is due to enhanced endogenous opioid signaling in response to potential reward, NTX should reduce such bias in the AA group. We found that NTX did not reliably reduce impulsive choice in the AA group; however, NTX's effect on choice bias across individuals was robustly predictable. NTX's effect on choice bias was significantly correlated with scores on Rotter's Locus of Control (LOC) scale; increasingly internal LOC scores predicted increasing likelihood of impulsive choices on NTX. In addition, we found that NTX significantly enhanced control of motor responses, particularly within the CS group. These results suggest that endogenous opioids may impair response selection during decision-making under conflict, and that NTX's effects on explicit decision-making are personality-dependent. Determining the biological basis of this dependence could have important implications for effective alcoholism treatment.

  18. White matter microstructure and developmental improvement of hyperactive/impulsive symptoms in attention-deficit/hyperactivity disorder.

    Science.gov (United States)

    Francx, Winke; Zwiers, Marcel P; Mennes, Maarten; Oosterlaan, Jaap; Heslenfeld, Dirk; Hoekstra, Pieter J; Hartman, Catharina A; Franke, Barbara; Faraone, Stephen V; O'Dwyer, Laurence; Buitelaar, Jan K

    2015-12-01

    A developmental improvement of symptoms in attention-deficit/hyperactivity disorder (ADHD) is frequently reported, but the underlying neurobiological substrate has not been identified. The aim of this study was to determine whether white matter microstructure is related to developmental improvement of ADHD symptoms. A cross-sectional magnetic resonance imaging (MRI) analysis was embedded in a prospective follow-up of an adolescent cohort of ADHD and control subjects (NeuroIMAGE). Mean age at baseline was 11.9 years, mean interval of follow-up was 5.9 years. About 75.3% of the original cohort was retained successfully. Data of 101 participants with ADHD combined type at baseline and 40 healthy controls were analysed. ADHD symptoms were measured with semistructured, investigator-based interviews and Conners' questionnaires, on the basis of DSM-IV criteria. Fractional anisotropy (FA) and mean diffusivity (MD) indices of white matter microstructure were measured using whole brain diffusion tensor imaging at follow-up only. In a dimensional analysis FA and MD were related to change in ADHD symptoms. To link this analysis to DSM-IV diagnoses, a post hoc categorical group analysis was conducted comparing participants with persistent (n = 59) versus remittent (n = 42) ADHD and controls. Over time, participants with ADHD showed improvement mainly in hyperactive/impulsive symptoms. This improvement was associated with lower FA and higher MD values in the left corticospinal tract at follow-up. Findings of the dimensional and the categorical analysis strongly converged. Changes in inattentive symptoms over time were minimal and not related to white matter microstructure. The corticospinal tract is important in the control of voluntary movements, suggesting the importance of the motor system in the persistence of hyperactive/impulsive symptoms. © 2015 Association for Child and Adolescent Mental Health.

  19. A web-based study of bipolarity and impulsivity in athletes engaging in extreme and high-risk sports.

    Science.gov (United States)

    Dudek, Dominika; Siwek, Marcin; Jaeschke, Rafał; Drozdowicz, Katarzyna; Styczeń, Krzysztof; Arciszewska, Aleksandra; Chrobak, Adrian A; Rybakowski, Janusz K

    2016-06-01

    We hypothesised that men and women who engage in extreme or high-risk sports would score higher on standardised measures of bipolarity and impulsivity compared to age and gender matched controls. Four-hundred and eighty extreme or high-risk athletes (255 males and 225 females) and 235 age-matched control persons (107 males and 128 females) were enrolled into the web-based case-control study. The Mood Disorder Questionnaire (MDQ) and Barratt Impulsiveness Scale (BIS-11) were administered to screen for bipolarity and impulsive behaviours, respectively. Results indicated that extreme or high-risk athletes had significantly higher scores of bipolarity and impulsivity, and lower scores on cognitive complexity of the BIS-11, compared to controls. Further, there were positive correlations between the MDQ and BIS-11 scores. These results showed greater rates of bipolarity and impulsivity, in the extreme or high-risk athletes, suggesting these measures are sensitive to high-risk behaviours.

  20. Gender-specific mediational links between parenting styles, parental monitoring, impulsiveness, drinking control, and alcohol-related problems.

    Science.gov (United States)

    Patock-Peckham, Julie A; King, Kevin M; Morgan-Lopez, Antonio A; Ulloa, Emilio C; Moses, Jennifer M Filson

    2011-03-01

    Recently, it has been suggested that traits may dynamically change as conditions change. One possible mechanism that may influence impulsiveness is parental monitoring. Parental monitoring reflects a knowledge regarding one's offspring's whereabouts and social connections. The aim of this investigation was to examine potential gender-specific parental influences to impulsiveness (general behavioral control), control over one's own drinking (specific behavioral control), and alcohol-related problems among individuals in a period of emerging adulthood. Direct and mediational links between parenting styles (permissive, authoritarian, and authoritative), parental monitoring, impulsiveness, drinking control, and alcohol-related problems were investigated. A multiple-group, SEM model with (316 women, 265 men) university students was examined. In general, the overall pattern among male and female respondents was distinct. For daughters, perceptions of a permissive father were indirectly linked to more alcohol-related problems through lower levels of monitoring by fathers and more impulsive symptoms. Perceptions of an authoritative father were also indirectly linked to fewer impulsive symptoms through higher levels of monitoring by fathers among daughters. For men, perceptions of a permissive mother were indirectly linked to more alcohol-related problems through lower levels of monitoring by mothers and more impulsive symptoms. For sons, perceptions of mother authoritativeness were indirectly linked to fewer alcohol-related problems through more monitoring by mothers and fewer impulsive symptoms. Monitoring by an opposite-gender parent mediated the link between parenting styles (i.e., permissive, authoritative) on impulsiveness.

  1. Impulsivity and Suicidality in Adolescent Inpatients.

    Science.gov (United States)

    Auerbach, Randy P; Stewart, Jeremy G; Johnson, Sheri L

    2017-01-01

    Suicide is the second leading cause of death among adolescents, and impulsivity has emerged as a promising marker of risk. The present study tested whether distinct domains of impulsivity are differentially associated with suicide ideation, plans, and attempts. Adolescents (n = 381; boys = 106, girls = 275) aged 13-19 years (M = 15.62, SD = 1.41) were recruited from an acute, residential treatment program. Within 48 h of admission to the hospital, participants were administered structured clinical interviews assessing mental health disorders and suicidality. Following these interviews, participants completed self-report questionnaires assessing symptom severity and impulsivity. Consistent with past research, an exploratory factor analysis of our 90-item impulsivity instrument resulted in a three-factor solution: Pervasive Influence of Feelings, Feelings Trigger Action, and Lack of Follow-Through. Concurrent analysis of these factors confirmed hypotheses of unique associations with suicide ideation and attempts in the past month. Specifically, whereas Pervasive Influence of Feelings (i.e., tendency for emotions to shape thoughts about the self and the future) is uniquely associated with greater suicidal ideation, Feelings Trigger Action (i.e., impulsive behavioral reactivity to emotions) is uniquely associated with the occurrence of suicide attempts, even after controlling for current psychiatric diagnoses and symptoms. Exploratory gender analyses revealed that these effects were significant in female but not male adolescents. These findings provide new insight about how specific domains of impulsivity differentially increase risk for suicide ideation and attempts. Implications for early identification and prevention of youth suicide are discussed.

  2. Original article Impulsive antisociality and executive control problems: evidence from go/no-go and stop-signal tasks

    Directory of Open Access Journals (Sweden)

    Jarosław M. Michałowski

    2015-03-01

    Full Text Available Background People with impulsive-antisocial traits may engage in unplanned behaviors that reduce their efficiency and may even result in harm to self and others. The present study aimed to investigate the relationship between executive control functions and impulsive antisociality, as assessed with the Psychopathic Personality Inventory (PPI. Using go/no-go and stop-signal paradigms, we examined whether healthy participants with high impulsive-antisocial traits would show delayed response inhibition and error monitoring deficits when compared to those reporting low levels of impulsive antisociality. Participants and procedure A total of 26 participants were recruited from different Warsaw universities based on the Impulsive Antisociality subscale scores of the PPI. Subjects scoring in the first quartile were assigned to the low and those with a score in the fourth quartile were selected for the high impulsivity group. All participants were tested with go/no-go and stop-signal tasks that were executed in a random order. Results Higher levels of impulsive-antisocial traits were associated with poorer executive control. In particular, high impulsive-antisocial individuals demonstrated reduced post-error slowing in response to go stimuli following an error and took longer to respond to the stop signal than the control group. The two groups did not differ in their performance accuracy. Conclusions The study extends previous findings regarding the relationship between impulsivity and executive control showing that non-clinical impulsive antisociality results in decreased conflict detection ability and delayed response inhibition. These problems may result in reduced executive effectiveness in everyday life situations.

  3. Personality differences in the susceptibility to stress-eating: The influence of emotional control and impulsivity.

    Science.gov (United States)

    Van Blyderveen, Sherry; Lafrance, Adele; Emond, Michael; Kosmerly, Stacey; O'Connor, Megan; Chang, Felicia

    2016-12-01

    Stress has been associated with deviations from typical eating patterns, with respect to both food choice and overall caloric intake. Both increases and decreases in dietary intake have been previously noted in response to stress. The purpose of the present study was to determine whether the affect regulation strategies of emotional control and impulsivity predict susceptibility to eating in response to stress. Specifically, it was anticipated that emotional suppression would predict decreases in caloric intake, whereas impulsivity would predict increases in caloric intake, in response to a stressor. Participants were randomly assigned to view either a video designed to elicit stress or a control video. Food was provided during the video and the amount and type of food consumed was measured. Participants' nutritional intake was greater in the stress condition than in the control condition. One aspect of affect regulation, impulsivity, moderated this relationship, with a tendency for greater impulsivity to be associated with greater caloric intake in the stress condition. The degree of negative affect that participants experienced in the stress condition predicted food choice and overall caloric intake. Both emotional control and impulsivity moderated the relationship between negative affect and both food choice and caloric intake in the stress condition. The present study highlights the importance of considering the personality attributes of both impulsivity and emotional suppression in understanding stress eating. Copyright © 2016. Published by Elsevier Ltd.

  4. Impulsive stabilization and impulsive synchronization of discrete-time delayed neural networks.

    Science.gov (United States)

    Chen, Wu-Hua; Lu, Xiaomei; Zheng, Wei Xing

    2015-04-01

    This paper investigates the problems of impulsive stabilization and impulsive synchronization of discrete-time delayed neural networks (DDNNs). Two types of DDNNs with stabilizing impulses are studied. By introducing the time-varying Lyapunov functional to capture the dynamical characteristics of discrete-time impulsive delayed neural networks (DIDNNs) and by using a convex combination technique, new exponential stability criteria are derived in terms of linear matrix inequalities. The stability criteria for DIDNNs are independent of the size of time delay but rely on the lengths of impulsive intervals. With the newly obtained stability results, sufficient conditions on the existence of linear-state feedback impulsive controllers are derived. Moreover, a novel impulsive synchronization scheme for two identical DDNNs is proposed. The novel impulsive synchronization scheme allows synchronizing two identical DDNNs with unknown delays. Simulation results are given to validate the effectiveness of the proposed criteria of impulsive stabilization and impulsive synchronization of DDNNs. Finally, an application of the obtained impulsive synchronization result for two identical chaotic DDNNs to a secure communication scheme is presented.

  5. Stabilization and Synchronization of Memristive Chaotic Circuits by Impulsive Control

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    Limin Zou

    2017-01-01

    Full Text Available The purpose of this note is to study impulsive control and synchronization of memristor based chaotic circuits shown by Muthuswamy. We first establish a less conservative sufficient condition for the stability of memristor based chaotic circuits. After that, we discuss the effect of errors on stability. Meanwhile, we also discuss impulsive synchronization of two memristor based chaotic systems. Our results are more general and more applicable than the ones shown by Yang, Li, and Huang. Finally, several numerical examples are given to show the effectiveness of our methods.

  6. Impulsivity but not sensation seeking is associated with opioid analgesic misuse risk in patients with chronic pain.

    Science.gov (United States)

    Marino, Elise N; Rosen, Kristen D; Gutierrez, Antonio; Eckmann, Maxim; Ramamurthy, Somayaji; Potter, Jennifer Sharpe

    2013-05-01

    Impulsivity and sensation seeking have been associated with substance use disorders, including opioid use disorders. This pilot study sought to examine whether impulsivity and sensation seeking, as measured by the Barratt Impulsiveness Scale (BIS) and Sensation Seeking Scale (SSS), were associated with opioid analgesic misuse risk in chronic, low-back pain patients prescribed opioid analgesics. Participants were 42 chronic, low-back pain patients enrolled in a larger study examining problematic opioid analgesic use. Impulsivity was assessed using the BIS, sensation seeking was measured using the SSS, and opioid analgesic misuse risk was assessed using the Current Opioid Misuse Measure (COMM). Significant bivariate associations were found between the COMM and the following predictor variables: age and the three BIS subscales: Attentional Impulsiveness, Non-planning Impulsiveness, and Motor Impulsiveness. Using a multivariate linear regression, after controlling for age, the BIS subscales accounted for 29.0% of the variance in the COMM. Attentional Impulsiveness was the only significant BIS subscale. These results suggest a potential relationship between impulsivity, but not sensation seeking, and risk for opioid analgesic misuse. Impulsivity is not a prominent trait observed in chronic pain patients; however, it may be an important risk factor for opioid analgesic misuse for a subset of individuals with chronic pain. As such, these findings suggest that additional exploration of this potential risk factor is warranted. Published by Elsevier Ltd.

  7. Treatment, alcoholics anonymous, and 16-year changes in impulsivity and legal problems among men and women with alcohol use disorders.

    Science.gov (United States)

    Blonigen, Daniel M; Timko, Christine; Moos, Bernice S; Moos, Rudolf H

    2009-09-01

    The link between impulsive personality traits and alcohol use disorders (AUDs) is well established. No studies, however, have investigated whether receipt of help for AUDs predicts change in impulsivity or whether such change is associated with relevant outcomes such as legal problems. The present study examined predictive associations between the duration of help for AUDs (Alcoholics Anonymous [AA], professional treatment) and impulsivity and legal problems over 16 years in men and women with AUDs. Participants who were initially untreated for their AUDs (n(men) = 332, n(women) = 296) completed follow-up telephone interviews at 1 and 16 years after their baseline assessment. Impulsivity and legal problems declined between baseline and the 1-year and 16-year follow-ups among both women and men. A longer duration of participation in AA predicted a decline in impulsivity at both follow-up assessments, and, in turn, a decline in impulsivity predicted a decline in legal problems at Years 1 and 16. In addition, a longer duration of participation in AA predicted fewer legal problems at Year 1, and this association was moderated by gender (significant in men) and impulsivity (significant for individuals with higher baseline scores). The results highlight the potential for AA and professional treatment to reduce the expression of impulsivity and related disinhibitory traits and legal problems in individuals with AUDs.

  8. Event-Based Impulsive Control of Continuous-Time Dynamic Systems and Its Application to Synchronization of Memristive Neural Networks.

    Science.gov (United States)

    Zhu, Wei; Wang, Dandan; Liu, Lu; Feng, Gang

    2017-08-18

    This paper investigates exponential stabilization of continuous-time dynamic systems (CDSs) via event-based impulsive control (EIC) approaches, where the impulsive instants are determined by certain state-dependent triggering condition. The global exponential stability criteria via EIC are derived for nonlinear and linear CDSs, respectively. It is also shown that there is no Zeno-behavior for the concerned closed loop control system. In addition, the developed event-based impulsive scheme is applied to the synchronization problem of master and slave memristive neural networks. Furthermore, a self-triggered impulsive control scheme is developed to avoid continuous communication between the master system and slave system. Finally, two numerical simulation examples are presented to illustrate the effectiveness of the proposed event-based impulsive controllers.

  9. Effects of STN and GPi deep brain stimulation on impulse control disorders and dopamine dysregulation syndrome.

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    Sarah J Moum

    Full Text Available Impulse control disorders (ICDs and dopamine dysregulation syndrome (DDS are important behavioral problems that affect a subpopulation of patients with Parkinson's disease (PD and typically result in markedly diminished quality of life for patients and their caregivers. We aimed to investigate the effects of subthalamic nucleus (STN and internal globus pallidus (GPi deep brain stimulation (DBS on ICD/DDS frequency and dopaminergic medication usage.A retrospective chart review was performed on 159 individuals who underwent unilateral or bilateral PD DBS surgery in either STN or GPi. According to published criteria, pre- and post-operative records were reviewed to categorize patients both pre- and post-operatively as having ICD, DDS, both ICD and DDS, or neither ICD nor DDS. Group differences in patient demographics, clinical presentations, levodopa equivalent dose (LED, and change in diagnosis following unilateral/bilateral by brain target (STN or GPi DBS placement were examined.28 patients met diagnostic criteria for ICD or DDS pre- or post-operatively. ICD or DDS classification did not differ by GPi or STN target stimulation. There was no change in DDS diagnosis after unilateral or bilateral stimulation. For ICD, diagnosis resolved in 2 of 7 individuals after unilateral or bilateral DBS. Post-operative development of these syndromes was significant; 17 patients developed ICD diagnoses post-operatively with 2 patients with pre-operative ICD developing DDS post-operatively.Unilateral or bilateral DBS did not significantly treat DDS or ICD in our sample, even though a few cases of ICD resolved post-operatively. Rather, our study provides preliminary evidence that DDS and ICD diagnoses may emerge following DBS surgery.

  10. Impulsivity and Concussion in Juvenile Rats: Examining Molecular and Structural Aspects of the Frontostriatal Pathway.

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    Harleen Hehar

    Full Text Available Impulsivity and poor executive control have been implicated in the pathogenesis of many developmental and neuropsychiatric disorders. Similarly, concussions/mild traumatic brain injuries (mTBI have been associated with increased risk for neuropsychiatric disorders and the development of impulsivity and inattention. Researchers and epidemiologists have therefore considered whether or not concussions induce symptoms of attention-deficit/hyperactivity disorder (ADHD, or merely unmask impulsive tendencies that were already present. The purpose of this study was to determine if a single concussion in adolescence could induce ADHD-like impulsivity and impaired response inhibition, and subsequently determine if inherent impulsivity prior to a pediatric mTBI would exacerbate post-concussion symptomology with a specific emphasis on impulsive and inattentive behaviours. As these behaviours are believed to be associated with the frontostriatal circuit involving the nucleus accumbens (NAc and the prefrontal cortex (PFC, the expression patterns of 8 genes (Comt, Drd2, Drd3, Drd4, Maoa, Sert, Tph1, and Tph2 from these two regions were examined. In addition, Golgi-Cox staining of medium spiny neurons in the NAc provided a neuroanatomical examination of mTBI-induced structural changes. The study found that a single early brain injury could induce impulsivity and impairments in response inhibition that were more pronounced in males. Interestingly, when animals with inherent impulsivity experienced mTBI, injury-related deficits were exacerbated in female animals. The single concussion increased dendritic branching, but reduced synaptic density in the NAc, and these changes were likely associated with the increase in impulsivity. Finally, mTBI-induced impulsivity was associated with modifications to gene expression that differed dramatically from the gene expression pattern associated with inherent impulsivity, despite very similar behavioural phenotypes. Our

  11. Impulsive Control for Continuous-Time Markov Decision Processes: A Linear Programming Approach

    Energy Technology Data Exchange (ETDEWEB)

    Dufour, F., E-mail: dufour@math.u-bordeaux1.fr [Bordeaux INP, IMB, UMR CNRS 5251 (France); Piunovskiy, A. B., E-mail: piunov@liv.ac.uk [University of Liverpool, Department of Mathematical Sciences (United Kingdom)

    2016-08-15

    In this paper, we investigate an optimization problem for continuous-time Markov decision processes with both impulsive and continuous controls. We consider the so-called constrained problem where the objective of the controller is to minimize a total expected discounted optimality criterion associated with a cost rate function while keeping other performance criteria of the same form, but associated with different cost rate functions, below some given bounds. Our model allows multiple impulses at the same time moment. The main objective of this work is to study the associated linear program defined on a space of measures including the occupation measures of the controlled process and to provide sufficient conditions to ensure the existence of an optimal control.

  12. The Effects of Oral d-Amphetamine on Impulsivity in Smoked and Intranasal Cocaine Users

    Science.gov (United States)

    Reed, Stephanie Collins; Evans, Suzette M.

    2016-01-01

    BACKGROUND Effective treatments for cocaine use disorders remain elusive. Two factors that may be related to treatment failures are route of cocaine used and impulsivity. Smoked cocaine users are more likely to have poorer treatment outcomes compared to intranasal cocaine users. Further, cocaine users are impulsive and impulsivity is associated with poor treatment outcomes. While stimulants are used to treat Attention Deficit Hyperactivity Disorder (ADHD) and attenuate certain cocaine-related behaviors, few studies have comprehensively examined whether stimulants can reduce behavioral impulsivity in cocaine users, and none examined route of cocaine use as a factor. METHODS The effects of immediate release oral d-amphetamine (AMPH) were examined in 34 cocaine users (13 intranasal, 21 smoked). Participants had three separate sessions where they were administered AMPH (0, 10, or 20 mg) and completed behavioral measures of impulsivity and risk-taking and subjective measures of abuse liability. RESULTS Smoked cocaine users were more impulsive on the Delayed Memory Task, the GoStop task and the Delay Discounting Task than intranasal cocaine users. Smoked cocaine users also reported more cocaine craving and negative mood than intranasal cocaine users. AMPH produced minimal increases on measures of abuse liability (e.g., Drug Liking). CONCLUSIONS Smoked cocaine users were more impulsive than intranasal cocaine users on measures of impulsivity that had a delay component. Additionally, although AMPH failed to attenuate impulsive responding, there was minimal evidence of abuse liability in cocaine users. These preliminary findings need to be confirmed in larger samples that control for route and duration of cocaine use. PMID:27114203

  13. Relationship of attention-deficit/hyperactivity disorder symptom severity with severity of alcohol-related problems in a sample of inpatients with alcohol use disorder

    Directory of Open Access Journals (Sweden)

    Bozkurt M

    2016-07-01

    Full Text Available Muge Bozkurt,1 Cuneyt Evren,1 Gokhan Umut,1 Bilge Evren2 1Research, Treatment and Training Center for Alcohol and Substance Dependence, Bakirkoy Prof Dr Mazhar Osman Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, 2Department of Psychiatry, Baltalimani State Hospital for Muskuloskeletal Disorders, Istanbul, Turkey Purpose: Attention-deficit/hyperactivity disorder (ADHD has been shown to be related to a higher risk of developing psychiatric problems such as depressive disorders, substance use disorder, and impulsivity. Adults who have comorbid ADHD and alcohol use disorder (AUD are at greater risk of negative outcomes. Thus, it is important to evaluate the relationship of ADHD symptoms and the severity of alcohol-related problems among patients with AUD. The aim of the present study was to evaluate the effect of ADHD symptoms on severity of alcohol-related problems, while controlling the effects of depression and impulsivity in a sample of inpatients with AUD. Patients and methods: Participants (n=190 were evaluated with the Beck Depression Inventory, the Short Form Barratt Impulsiveness Scale, the Michigan Alcohol Screening Test, and the Adult ADHD Self-Report Scale. Results: Severity of the scale scores was positively correlated with each other. Although severity of depression and impulsivity (particularly non-planning impulsivity predicted the severity of alcohol-related problems in a linear regression model, when severity of ADHD symptoms was included in the analysis, the inattentive subscale score, in particular, predicted the severity of alcohol-related problems together with non-planning impulsivity, whereas depression was no longer a predictor. Conclusion: These findings suggest that, together with non-planning impulsivity, symptoms of ADHD (particularly inattentive factor are an important factor that predict alcohol-related problems, while controlling the severity of depressive symptoms among inpatients

  14. Intermittent Explosive Disorder

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    Lut Tamam

    2011-09-01

    Full Text Available Intermittent explosive disorder is an impulse control disorder characterized by the occurrence of discrete episodes of failure to resist aggressive impulses that result in violent assault or destruction of property. Though the prevalence intermittent explosive disorder has been reported to be relatively rare in frontier studies on the field, it is now common opinion that intermittent explosive disorder is far more common than previously thought especially in clinical psychiatry settings. Etiological studies displayed the role of both psychosocial factors like childhood traumas and biological factors like dysfunctional neurotransmitter systems and genetics. In differential diagnosis of the disorder, disorders involving agression as a symptom such as alcohol and drug intoxication, antisocial and borderline personality disorders, personality changes due to general medical conditions and behavioral disorder should be considered. A combination of pharmacological and psychotherapeutic approaches are suggested in the treatment of the disorder. This article briefly reviews the historical background, diagnostic criteria, epidemiology, etiology and treatment of intermittent explosive disorder.

  15. Ventral striatal regulation of CREM mediates impulsive action and drug addiction vulnerability

    OpenAIRE

    Miller, Michael L.; Ren, Yanhua; Szutorisz, Henrietta; Warren, Noël A.; Tessereau, Chloé; Egervári, Gábor; Mlodnicka, Agnieszka; Kapoor, Manav; Chaarani, Bader; Morris, Claudia V.; Schumann, Gunter; Garavan, Hugh; Goate, Alison M.; Bannon, Michael J.; Halperin, Jeffrey M.

    2017-01-01

    Impulsivity, a multifaceted behavioral hallmark of attention-deficit/hyperactivity disorder (ADHD), strongly influences addiction vulnerability and other psychiatric disorders that incur enormous medical and societal burdens yet the neurobiological underpinnings linking impulsivity to disease remain poorly understood. Here we report the critical role of ventral striatal cAMP-response element modulator (CREM) in mediating impulsivity relevant to drug abuse vulnerability. Using an ADHD rat mode...

  16. Substance Use in Undergraduate Students With Histories of Attention-Deficit/Hyperactivity Disorder (ADHD): The Role of Impulsivity.

    Science.gov (United States)

    Egan, Theresa E; Dawson, Anne E; Wymbs, Brian T

    2017-08-24

    Emerging adulthood (18-25 years old) is regarded as a time of identity exploration that includes a peak in risky behaviors, such as substance use and misuse. Attention-deficit/hyperactivity disorder (ADHD) is also associated with greater levels of risky behaviors, including substance use and misuse; however, there is a lack of research on substance use by emerging adults with ADHD, in particular the potential mechanisms that may facilitate this risk. The present study builds on the existing research regarding the association between ADHD and substance use by examining roles of multiple facets of impulsivity in facilitating this association during emerging adulthood. In a sample of 197 undergraduate students (24 students with an ADHD diagnostic history), we assessed for components of impulsivity (e.g., urgency, sensation-seeking) and rates of alcohol abuse, tobacco use, cannabis use, illicit drug use, and stimulant medication misuse within the past year. Findings indicate that facets of impulsivity, as a whole, explained the association between an ADHD diagnostic history and both illicit drug use and alcohol abuse such that students with ADHD histories tended to report higher levels of impulsivity, which increased risk of alcohol abuse and illicit drug use. Higher levels of specific facets of impulsivity, particularly negative urgency, also facilitated associations between having ADHD and engaging in most forms of substance use tested herein. Conclusions/Importance: Specific facets of impulsivity appear to be important mediators of the association between ADHD and substance use, and should be considered as potential targets of substance use interventions for this population.

  17. The Right Superior Frontal Gyrus and Individual Variation in Proactive Control of Impulsive Response.

    Science.gov (United States)

    Hu, Sien; Ide, Jaime S; Zhang, Sheng; Li, Chiang-Shan R

    2016-12-14

    A hallmark of cognitive control is the ability to rein in impulsive responses. Previously, we used a Bayesian model to describe trial-by-trial likelihood of the stop signal or p(Stop) and related regional activations to p(Stop) to response slowing in a stop signal task. Here, we characterized the regional processes of conflict anticipation in association with intersubject variation in impulse control in 114 young adults. We computed the stop signal reaction time (SSRT) and a measure of motor urgency, indexed by the reaction time (RT) difference between go and stop error trials or "GoRT - SERT," where GoRT is the go trial RT and SERT is the stop error RT. Motor urgency and SSRT were positively correlated across subjects. A linear regression identified regional activations to p(Stop), each in correlation with SSRT and motor urgency. We hypothesized that shared neural activities mediate the correlation between motor urgency and SSRT in proactive control of impulsivity. Activation of the ventromedial prefrontal cortex, posterior cingulate cortex and right superior frontal gyrus (SFG) during conflict anticipation correlated negatively with the SSRT. Activation of the right SFG also correlated negatively with GoRT - SERT. Therefore, activation of the right SFG was associated with more efficient response inhibition and less motor urgency. A mediation analysis showed that right SFG activation to conflict anticipation mediates the correlation between SSRT and motor urgency bidirectionally. The current results highlight a specific role of the right SFG in translating conflict anticipation to the control of impulsive response, which is consistent with earlier studies suggesting its function in action restraint. Individuals vary in impulse control. However, the neural bases underlying individual variation in proactive control of impulsive responses remain unknown. Here, in a large sample of young adults, we showed that activation of the right superior frontal gyrus (SFG

  18. [Validation of the French translation of the impulsive nonconformity scale].

    Science.gov (United States)

    Foullu, S; Blanc-Foullu, S; Danet, F; Dumas, P; Brunelin, J; Travart, M; Elchardus, J-M; Saoud, M; d'Amato, T

    2008-12-01

    Impulsive traits are key characteristics in a lot of psychiatric disorders and are part of the "normal" behaviour spectrum. Although impulsivity is a controversial concept, some questionnaires have focused on its "dysfunctional" aspect. The Barratt Impulsive Scale (BIS-10) is the scale the most used to explore impulsiveness, but it does not explore antisocial or nonconform behaviour. The Chapman Impulsive and Nonconformity Scale (INCS) is a questionnaire of 51 items that measures the impulsivity and nonconformism. The INCS reflects "failure to internalize societal norms, lack of empathy for the pain of others, and an unrestrained yielding to impulse and self-gratification" and was originally designed to assess psychosis proneness. It has been validated in the USA, but has not yet been validated in France. Interestingly, although it was not predictive of psychosis, high scorers on INCS exceeded controls on depression, and on rates of substance abuse. Furthermore, participants scoring high on hypomanic personality scale and INCS were found to have an especially heightened risk for bipolar disorders. To translate and determine reliability and validity of the French version of the Chapman Impulsive and Nonconformity Scale in young adults by comparison with the BIS. Chapman Impulsive and Nonconformity Scale has been back-translated into French, and filled out by 237 students (males: 104; females: 133; mean age: 20.4 [range 19-25]). BIS-10 was used for convergent validity. Each participant completed the two scales. Reliability and validity of the French form of INCS were assessed with the internal consistency (coefficient alpha of Cronbach and the split half reliability) and the convergent validity. In the French version of the INCS, the 51 items have high internal reliability (Cronbach's alpha=0.81 and split half reliability=0.80). Concerning the BIS, internal reliability is good (Cronbach's alpha=0.72 and split half reliability=0.66). Moreover, Pearson's r of the INCS

  19. Profiles of drug addicts in relation to personality variables and disorders.

    Science.gov (United States)

    Carou, María; Romero, Estrella; Luengo, Mª Ángeles

    2016-10-07

    In recent decades, research has identified a set of impulsive/disinhibited personality variables closely associated with drug addiction. As well as this, disorders linked with these variables, such as ADHD and personality disorders, are being closely studied in the field of drug addiction. Although much knowledge has been accumulated about the relation of these variables and disorders taken separately, less is known about how these constructs allow identify-specific profiles within the drug dependent population to be identified. This work, on the basis of data collected on a sample of drug addicts in treatment, analyzes how impulsiveness, sensation seeking, self-control, ADHD and personality disorders contribute to identifying specific profiles of addicts. Cluster analysis allowed two profiles to be outlined according to these personality and psychopathology characteristics. Self-control, impulsiveness, impulsive and antisocial personality disorders, as well as scores in ADHD, emerge as the variables that contribute more to profile differentiation. One of these profiles (56.1% of participants) with a high disinhibition pattern, is associated with severe indicators of consumption and criminal career patterns. These results allow us to emphasize the role of personality and impulsiveness-related disorders in the identification of distinctive profiles within the addict population, and suggest the need to generate treatment strategies adapted to personal/psychopathology configurations of drug addicts.

  20. Childhood inhibitory control and adolescent impulsivity and novelty seeking as differential predictors of relational and overt aggression.

    Science.gov (United States)

    Sarkisian, Katherine; Van Hulle, Carol; Lemery-Chalfant, Kathryn; Goldsmith, H H

    2017-04-01

    Impulsivity is commonly conflated with novelty seeking, but these traits are conceptually independent and hold different predictive implications. Using a multi-informant, longitudinal design, we examined childhood inhibitory control, as well as adolescent impulsivity and novelty seeking, as predictors of aggression in a sample of 976 twins. Lower childhood inhibitory control and higher adolescent impulsivity predicted both overt and relational aggression in regression analyses that accounted for sex, puberty status, age, and socioeconomic status. As predicted, novelty seeking did not predict aggression, a finding that supports its independence from impulsivity.

  1. [Kleptomania: an irresistible impulse].

    Science.gov (United States)

    Hatzigeorgiou, K

    2011-01-01

    This review presents the historical-epidemiological and clinical aspects of Kleptomania. The diagnostic criteria, on the basis of which it is categorized in the group of Impulse Control Disorders, are defined precisely. All the aspects of its causative pathogenesis are deeply analyzed, as they are projected through its phenomenological, psychoanalytical and psycho-biological approach. Particular emphasis is given on its differential diagnosis from other psycho-pathological conditions and especially from the co-morbidities that often accompany it. The frame of treatment is established and its course and the final outcome are analyzed. Finally, it is determined what should be the objectives of future research, which will contribute decisively to the ascertainment of the exact incidence of Kleptomania in the general population, to the clarification of its causative pathogenesis and especially to the most effective treatment of this serious mental disorder.

  2. Candidate genetic pathways for attention-deficit/hyperactivity disorder (ADHD) show association to hyperactive/impulsive symptoms in children with ADHD.

    Science.gov (United States)

    Bralten, Janita; Franke, Barbara; Waldman, Irwin; Rommelse, Nanda; Hartman, Catharina; Asherson, Philip; Banaschewski, Tobias; Ebstein, Richard P; Gill, Michael; Miranda, Ana; Oades, Robert D; Roeyers, Herbert; Rothenberger, Aribert; Sergeant, Joseph A; Oosterlaan, Jaap; Sonuga-Barke, Edmund; Steinhausen, Hans-Christoph; Faraone, Stephen V; Buitelaar, Jan K; Arias-Vásquez, Alejandro

    2013-11-01

    Because multiple genes with small effect sizes are assumed to play a role in attention-deficit/hyperactivity disorder (ADHD) etiology, considering multiple variants within the same analysis likely increases the total explained phenotypic variance, thereby boosting the power of genetic studies. This study investigated whether pathway-based analysis could bring scientists closer to unraveling the biology of ADHD. The pathway was described as a predefined gene selection based on a well-established database or literature data. Common genetic variants in pathways involved in dopamine/norepinephrine and serotonin neurotransmission and genes involved in neuritic outgrowth were investigated in cases from the International Multicentre ADHD Genetics (IMAGE) study. Multivariable analysis was performed to combine the effects of single genetic variants within the pathway genes. Phenotypes were DSM-IV symptom counts for inattention and hyperactivity/impulsivity (n = 871) and symptom severity measured with the Conners Parent (n = 930) and Teacher (n = 916) Rating Scales. Summing genetic effects of common genetic variants within the pathways showed a significant association with hyperactive/impulsive symptoms ((p)empirical = .007) but not with inattentive symptoms ((p)empirical = .73). Analysis of parent-rated Conners hyperactive/impulsive symptom scores validated this result ((p)empirical = .0018). Teacher-rated Conners scores were not associated. Post hoc analyses showed a significant contribution of all pathways to the hyperactive/impulsive symptom domain (dopamine/norepinephrine, (p)empirical = .0004; serotonin, (p)empirical = .0149; neuritic outgrowth, (p)empirical = .0452). The present analysis shows an association between common variants in 3 genetic pathways and the hyperactive/impulsive component of ADHD. This study demonstrates that pathway-based association analyses, using quantitative measurements of ADHD symptom domains, can increase the power of genetic analyses to

  3. An error-related negativity potential investigation of response monitoring function in individuals with Internet addiction disorder

    Directory of Open Access Journals (Sweden)

    Zhenhe eZhou

    2013-09-01

    Full Text Available Internet addiction disorder (IAD is an impulse disorder or at least related to impulse control disorder. Deficits in executive functioning, including response monitoring, have been proposed as a hallmark feature of impulse control disorders. The error-related negativity (ERN reflects individual’s ability to monitor behavior. Since IAD belongs to a compulsive-impulsive spectrum disorder, theoretically, it should present response monitoring functional deficit characteristics of some disorders, such as substance dependence, ADHD or alcohol abuse, testing with an Erikson flanker task. Up to now, no studies on response monitoring functional deficit in IAD were reported. The purpose of the present study was to examine whether IAD displays response monitoring functional deficit characteristics in a modified Erikson flanker task.23 subjects were recruited as IAD group. 23 matched age, gender and education healthy persons were recruited as control group. All participants completed the modified Erikson flanker task while measured with event-related potentials (ERPs. IAD group made more total error rates than did controls (P < 0.01; Reactive times for total error responses in IAD group were shorter than did controls (P < 0.01. The mean ERN amplitudes of total error response conditions at frontal electrode sites and at central electrode sites of IAD group were reduced compared with control group (all P < 0.01. These results revealed that IAD displays response monitoring functional deficit characteristics and shares ERN characteristics of compulsive-impulsive spectrum disorder.

  4. Impairment in delay discounting in schizophrenia and schizoaffective disorder but not primary mood disorders.

    Science.gov (United States)

    Brown, Hannah E; Hart, Kamber L; Snapper, Leslie A; Roffman, Joshua L; Perlis, Roy H

    2018-05-28

    A measure of planning and impulse control, the delay-discounting (DD) task estimates the extent to which an individual decreases the perceived value of a reward as the reward is delayed. We examined cross-disorder performance between healthy controls (n = 88), individuals with bipolar disorder (n = 23), major depressive disorder (n = 43), and primary psychotic disorders (schizophrenia and schizoaffective disorder; n = 51) on the DD task (using a $10 delayed larger reward), as well as the interaction of DD scores with other symptom domains (cognition, psychosis, and affect). We found that individuals with schizophrenia and schizoaffective disorder display significantly greater rates of discounting compared to healthy controls, while individuals with a primary mood disorder do not differ from healthy controls after adjustment for IQ. Further, impairment in working memory is associated with higher discounting rates among individuals with schizophrenia and schizoaffective disorder, but cognitive dysfunction alone does not account for the extent of impairment in DD. Taken together, these results suggest an impaired ability to plan for the future and make adaptive decisions that are specific to individuals with psychotic disorders, and likely related to adverse functional outcomes. More generally, this work demonstrates the presence of variation in impulsivity across major psychiatric illnesses, supporting the use of a trans-diagnostic perspective.

  5. The relevance of personality traits in impulsivity-related disorders: From substance use disorders and gambling disorder to bulimia nervosa.

    Science.gov (United States)

    Del Pino-Gutiérrez, Amparo; Jiménez-Murcia, Susana; Fernández-Aranda, Fernando; Agüera, Zaida; Granero, Roser; Hakansson, Anders; Fagundo, Ana B; Bolao, Ferran; Valdepérez, Ana; Mestre-Bach, Gemma; Steward, Trevor; Penelo, Eva; Moragas, Laura; Aymamí, Neus; Gómez-Peña, Mónica; Rigol-Cuadras, Assumpta; Martín-Romera, Virginia; Menchón, José M

    2017-09-01

    Background and aims The main aim of this study was to analyze and describe the clinical characteristics and shared personality traits in different impulsivity-compulsivity spectrum disorders: substance use disorders (SUD), gambling disorder (GD), and bulimia nervosa (BN). The specific aims were to compare personality differences among individuals with pure SUD, BN with and without SUD, and GD with and without SUD. In addition, we assessed the differential predictive capacity of clinical and personality variables in relation to diagnostic subtype. Methods The sample comprised 998 subjects diagnosed according to DSM-IV-TR criteria: 101 patients were diagnosed with SUD, 482 with GD, 359 with BN, 11 with GD + SUD, and 45 patients with BN + SUD. Various assessment instruments were administered, as well as other clinical measures, to evaluate their predictive capacity. Results Marked differences in personality traits were observed between groups. Novelty seeking, harm avoidance, self-directedness, cooperation, and self-transcendence best differentiated the groups. Notably, novelty seeking was significantly higher in the two dual pathology subgroups. Patients with dual pathology showed the most dysfunctional personality profiles. Discussion and conclusion Our results indicate the existence of shared dysfunctional personality traits among the groups studied, especially in novelty seeking and self-directedness.

  6. Impulsive control for a Takagi–Sugeno fuzzy model with time-delay and its application to chaotic systems

    International Nuclear Information System (INIS)

    Shi-Guo, Peng; Si-Min, Yu

    2009-01-01

    A control approach where the fuzzy logic methodology is combined with impulsive control is developed for controlling some time-delay chaotic systems in this paper. We first introduce impulses into each subsystem with delay of the Takagi–Sugeno (TS) fuzzy IF–THEN rules and then present a unified TS impulsive fuzzy model with delay for chaos control. Based on the new model, a simple and unified set of conditions for controlling chaotic systems is derived by the Lyapunov–Razumikhin method, and a design procedure for estimating bounds on control matrices is also given. Several numerical examples are presented to illustrate the effectiveness of this method

  7. Childhood Reports of Food Neglect and Impulse Control Problems and Violence in Adulthood

    Directory of Open Access Journals (Sweden)

    Michael G. Vaughn

    2016-03-01

    Full Text Available Food insecurity and hunger during childhood are associated with an array of developmental problems in multiple domains, including impulse control problems and violence. Unfortunately, extant research is based primarily on small convenience samples and an epidemiological assessment of the hunger-violence link is lacking. The current study employed data from Wave 1 (2001–2002 and Wave 2 (2004–2005 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC. The NESARC is a nationally representative sample of non-institutionalized U.S. residents aged 18 years and older. Participants who experienced frequent hunger during childhood had significantly greater impulsivity, worse self-control, and greater involvement in several forms of interpersonal violence. These effects were stronger among whites, Hispanics, and males. The findings support general theoretical models implicating impulse control problems as a key correlate of crime and violence and add another facet to the importance of ameliorating food neglect in the United States.

  8. Impulsive traits and 5-HT2A receptor promoter polymorphism in alcohol dependents: Possible association but no influence of personality disorders

    OpenAIRE

    Preuss, Ulrich W.; Koller, G.; Bondy, Brigitta; Bahlmann, Miriam; Soyka, Michael

    2001-01-01

    Objective: Impulsive behavior in alcoholics puts them at serious risk of severer course of disease and has been related to the serotonergic neurotransmission dysfunction. The aim of this study is to investigate the association between impulsive aggression in alcohol dependents with regard to the G-1438A polymorphism in the promoter region of the 5-HT2A receptor gene. Furthermore, we investigated the statistical interaction between 5-HT2A alleles, antisocial personality disorder (APD) and impu...

  9. Sleep disorders are associated with impulsivity in school children aged 8 to 10 years Distúrbios de sono associam-se com impulsividade em escolares de 8 a 10 anos de idade

    Directory of Open Access Journals (Sweden)

    Marilaine Medeiros

    2005-09-01

    Full Text Available CONTEXT: Sleep has an important function in the physical and emotional development of children. Some studies suggest an association between impulsivity and sleep disorders. However, little is known about this association in schoolchildren aged 8 to 10 years. METHOD: We studied 1180 children, 547 with sleep disorders (SD and 633 without SD (control group, classified with SD questionnaires. Within the SD group, 53 children with sleep-related respiratory disorders (SRRD and 521 children with non-respiratory sleep disorders (NRSD were analyzed. We acessed emotional indicators of impulsivity with Bender test. RESULTS: More SD children presented impulsivity than control group (pCONTEXTO: O sono tem função importante no desenvolvimento físico e emocional das crianças. Alguns estudos sugerem a associação de impulsividade e distúrbios do sono, sendo pouco conhecida esta associação em escolares na faixa etária de 8 a 10 anos. MÉTODO: Estudamos 1180 crianças, 547 com distúrbio do sono (DS e 633 normais (grupo controle, classificadas através de questionários sobre distúrbios do sono. Dentro do grupo DS, analisamos separadamente as crianças com distúrbio respiratório relacionado ao sono (DRRS e com distúrbios não respiratórios do sono (DNRS. Aplicamos o Teste Gestáltico de Bender (TB para detectar os indicadores emocionais de impulsividade. RESULTADOS: Maior número de crianças com DS apresentaram impulsividade em relação às crianças do grupo controle (p<0,05. Mais crianças de 10 anos de idade do grupo DNRS apresentaram impulsividade em relação ao grupo controle da mesma idade (p=0,001. Impulsividade e DRRS estiveram associados apenas entre as crianças de 8 anos de idade (p<0,05. CONCLUSÃO: Crianças com DS em geral, crianças com DRRS de 8 anos de idade, e crianças com 10 anos de idade do grupo DNRS apresentaram maior proporção de indicadores de impulsividade do que crianças do grupo controle.

  10. Numerical Algorithms for Deterministic Impulse Control Models with Applications

    NARCIS (Netherlands)

    Grass, D.; Chahim, M.

    2012-01-01

    Abstract: In this paper we describe three different algorithms, from which two (as far as we know) are new in the literature. We take both the size of the jump as the jump times as decision variables. The first (new) algorithm considers an Impulse Control problem as a (multipoint) Boundary Value

  11. Single versus multiple impulse control disorders in Parkinson's disease: an ¹¹C-raclopride positron emission tomography study of reward cue-evoked striatal dopamine release.

    Science.gov (United States)

    Wu, Kit; Politis, Marios; O'Sullivan, Sean S; Lawrence, Andrew D; Warsi, Sarah; Bose, Subrata; Lees, Andrew J; Piccini, Paola

    2015-06-01

    Impulse control disorders (ICDs) are reported in Parkinson's disease (PD) in association with dopaminergic treatment. Approximately 25 % of patients with ICDs have multiple co-occurring ICDs (i.e. more than one diagnosed ICD). The extent to which dopaminergic neurotransmission in PD patients with multiple ICDs differs from those with only one diagnosed ICD is unknown. The aims of this study are: (1) to investigate dopamine neurotransmission in PD patients diagnosed with multiple ICDs, single ICDs and non-ICD controls in response to reward-related visual cues using positron emission tomography with (11)C-raclopride. (2) to compare clinical features of the above three groups. PD individuals with mulitple ICDs (n = 10), single ICD (n = 7) and no ICDs (n = 9) were recruited and underwent two positron emission tomography (PET) scans with (11)C-raclopride: one where they viewed neutral visual cues and the other where they viewed a range of visual cues related to different rewards. Individuals with both multiple ICDs and single ICDs showed significantly greater ventral striatal dopamine release compared to non-ICD PD individuals in response to reward cues, but the two ICD groups did not differ from each other in the extent of dopamine release. Subjects with multiple ICDs were, however, significantly more depressed, and had higher levels of impulsive sensation-seeking compared to subjects with single ICDs and without ICDs. This is the first study to compare dopamine neurotransmission using PET neuroimaging in PD subjects with multiple vs. single ICDs. Our results suggest that striatal dopamine neurotransmission is not directly related to the co-occurrence of ICDs in PD, potentially implicating non-dopaminergic mechanisms linked to depression; and suggest that physicians should be vigilant in managing depression in PD patients with ICDs.

  12. [Compulsive buying disorder: a review and a case vignette].

    Science.gov (United States)

    Tavares, Hermano; Lobo, Daniela Sabbatini S; Fuentes, Daniel; Black, Donald W

    2008-05-01

    Compulsive buying disorder was first described as a psychiatric syndrome in the early twentieth century. Its classification remains elusive, and investigators have debated its potential relationship to mood, substance use, obsessive-compulsive, and impulse control disorders. The objective of this study is to present a review of compulsive buying disorder and present a case vignette. Two databases were reviewed (Medline and PsycINFO) in search for articles published in the last 40 years. Selected terms included oniomania, compulsive buying, and compulsive shopping. Other relevant articles were also identified through reference lists. Compulsive buying disorder is a prevalent and chronic condition that is found worldwide, sharing commonalities with impulse control disorders. In clinical samples, women make up more than 80% of subjects. Its etiology is unknown, but neurobiologic and genetic mechanisms have been proposed. The disorder is highly comorbid with mood, substance use, eating and impulse control disorders. Treatment recommendations derived from the literature and clinical experience suggest that problem shoppers can benefit from psychosocial interventions. Cognitive-behavioral group models appear promising. Medication trials have reported mixed results. The identification and treatment of psychiatric comorbidity is also a key aspect of treatment. In order to determine the validity of compulsive buying disorder, future work should focus on psychopathology and neurobiological findings unique to the syndrome.

  13. Comorbid personality disorders and violent behavior in psychotic patients.

    Science.gov (United States)

    Volavka, Jan

    2014-03-01

    Schizophrenia without any comorbidity confers a modest, but statistically significant elevation of the risk for violence. That risk is considerably increased by comorbid antisocial personality disorder or psychopathy as well as by comorbid substance use disorders. These comorbidities are frequent. Conduct disorder and conduct disorder symptoms elevate the risk for aggressive behavior in patients with schizophrenia. Violence among adults with schizophrenia may follow at least two distinct pathways-one associated with premorbid conditions, including antisocial conduct, and another associated with the acute psychopathology of schizophrenia. Aggressive behavior in bipolar disorder occurs mainly during manic episodes, but it remains elevated in euthymic patients in comparison with controls. The risk of violent behavior is increased by comorbidity with borderline personality disorder, antisocial personality disorder, and substance use disorders. These comorbidities are frequent. Borderline personality disorder and bipolar disorder are related in their phenomenology and response to medication. These two disorders share a tendency to impulsiveness, and impulsive behavior, including impulsive aggression, is particularly expressed when they co-occur.

  14. The relationship of impulsivity and cortical thickness in depressed and non-depressed adolescents.

    Science.gov (United States)

    Fradkin, Yuli; Khadka, Sabin; Bessette, Katie L; Stevens, Michael C

    2017-10-01

    Major Depressive Disorder (MDD) is recognized to be heterogeneous in terms of brain structure abnormality findings across studies, which might reflect previously unstudied traits that confer variability to neuroimaging measurements. The purpose of this study was to examine the relationships between different types of trait impulsivity and MDD diagnosis on adolescent brain structure. We predicted that adolescents with depression who were high on trait impulsivity would have more abnormal cortical structure than depressed patients or non-MDD who were low on impulsivity. We recruited 58 subjects, including 29 adolescents (ages 12-19) with a primary DSM-IV diagnosis of MDD and a history of suicide attempt and 29 demographically-matched healthy control participants. Our GLM-based analyses sought to describe differences in the linear relationships between cortical thickness and impulsivity trait levels. As hypothesized, we found significant moderation effects in rostral middle frontal gyrus and right paracentral lobule cortical thickness for different subscales of the Barratt Impulsiveness Scale. However, although these brain-behavior relationships differed between diagnostic study groups, they were not simple additive effects as we had predicted. For the middle frontal gyrus, non-MDD participants showed a strong positive association between cortical thickness and BIS-11 Motor scores, while MDD-diagnosed participants showed a negative association. For Non-Planning Impulsiveness, paracentral lobule cortical thickness was observed with greater impulsivity in MDD, but no association was found for controls. In conclusion, the findings confirm that dimensions of impulsivity have discrete neural correlates, and show that relationships between impulsivity and brain structure are expressed differently in adolescents with MDD compared to non-MDD.

  15. The Relationship Between Emotion Dysregulation and Impulsive Aggression in Veterans With Posttraumatic Stress Disorder Symptoms.

    Science.gov (United States)

    Miles, Shannon R; Menefee, Deleene S; Wanner, Jill; Teten Tharp, Andra; Kent, Thomas A

    2016-06-01

    While Veterans in general are no more dangerous than the civilian population, Veterans with posttraumatic stress disorder (PTSD) have stronger associations with anger and hostility and certain forms of aggression, such as intimate partner violence, than civilians with PTSD. This is alarming because up to 21% of Veterans seeking Veterans Affairs (VA) health care are diagnosed with PTSD. Emotion regulation difficulties (emotion dysregulation) are also related to increased PTSD symptom severity and may play a role in aggressive behavior. Because the predominant form of aggression in PTSD appears to be the impulsive subtype, the authors sought to clarify the relationship between PTSD, emotion dysregulation, and impulsive aggression. We examined how emotion dysregulation influenced impulsive aggression in a Veteran sample (N = 479) seeking treatment for trauma sequelae. All Veterans completed measures that assessed demographic information, emotion dysregulation, aggression frequency and subtype, and PTSD symptoms. Men generally reported more aggression than women. The emotion dysregulation, aggression, and PTSD measures were significantly correlated. Two cross-sectional mediation models showed emotion dysregulation fully accounted for the relationship between PTSD and impulsive aggression (indirect path for men: b = .07, SE = .026, bias-correct and accelerated confidence interval [BCa CI] = [0.02, 0.13]; indirect path for women: b = .08, SE = .022, BCa CI = [0.05, 0.13]). PTSD can increase negative emotions yet does not always lead to aggressive behaviors. The ability to regulate emotions may be pivotal to inhibiting aggression in those with PTSD. PTSD interventions may benefit from augmentation with emotion regulation skills training. © The Author(s) 2015.

  16. Markers of impaired motor and cognitive volition in Parkinson's disease: Correlates of dopamine dysregulation syndrome, impulse control disorder, and dyskinesias.

    Science.gov (United States)

    Hinkle, Jared T; Perepezko, Kate; Rosenthal, Liana S; Mills, Kelly A; Pantelyat, Alexander; Mari, Zoltan; Tochen, Laura; Bang, Jee Yun; Gudavalli, Medha; Yoritomo, Nadine; Butala, Ankur; Bakker, Catherine C; Johnson, Vanessa; Moukheiber, Emile; Dawson, Ted M; Pontone, Gregory M

    2018-02-01

    Dopaminergic therapy in Parkinson's disease (PD) can be associated with both motoric (e.g., dyskinesias) and neuropsychiatric adverse effects. Examples of the latter include Dopamine Dysregulation Syndrome (DDS) and impulse control disorder (ICD), which are separate but related behavioral/psychiatric complications of treatment in PD. Dysregulation of volition characterizes both dyskinesias and DDS/ICD; thus, we analyzed potential disease-related correlates in a large PD cohort. We analyzed cross-sectional data from 654 participants collected through the NINDS Parkinson's Disease Biomarkers Program. DDS/ICD symptoms and dyskinesias were assessed using the Movement Disorders Society (revised) Unified Parkinson's Disease Rating Scale. Potential associated variables were selected from PD-validated or PD-specific scales of neuropsychiatric or motoric status. Multivariable models with DDS/ICD or dyskinesia presence outcomes were produced with backward stepwise regression to identify factors independently associated with DDS/ICD and/or dyskinesias. Fifty-three (8.1%) participants endorsed DDS and/or ICD symptoms and 150 (22.9%) were dyskinetic. In multivariable analysis, psychosis was independently associated with both dyskinesias (p = 0.006) and DDS/ICD (p < 0.001). Unpredictable motor fluctuations (p = 0.026) and depression (p = 0.023) were also associated with DDS/ICD; female sex (p = 0.025), low tremor score (p = 0.001) and high akinesia-rigidity score (p < 0.001) were associated with dyskinesias. Our findings suggest that psychosis may be an important marker of impaired volition across motor and cognitive domains. Unpredictable motor fluctuations, psychosis, and depression may together comprise a phenotypic profile of patients at increased risk for DDS/ICD. Similarly, dyskinetic PD patients should be closely monitored for psychotic symptoms and treated appropriately. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Complex Dynamical Behaviors in a Predator-Prey System with Generalized Group Defense and Impulsive Control Strategy

    Directory of Open Access Journals (Sweden)

    Shunyi Li

    2013-01-01

    Full Text Available A predator-prey system with generalized group defense and impulsive control strategy is investigated. By using Floquet theorem and small amplitude perturbation skills, a local asymptotically stable prey-eradication periodic solution is obtained when the impulsive period is less than some critical value. Otherwise, the system is permanent if the impulsive period is larger than the critical value. By using bifurcation theory, we show the existence and stability of positive periodic solution when the pest eradication lost its stability. Numerical examples show that the system considered has more complicated dynamics, including (1 high-order quasiperiodic and periodic oscillation, (2 period-doubling and halving bifurcation, (3 nonunique dynamics (meaning that several attractors coexist, and (4 chaos and attractor crisis. Further, the importance of the impulsive period, the released amount of mature predators and the degree of group defense effect are discussed. Finally, the biological implications of the results and the impulsive control strategy are discussed.

  18. Impulse: Memory System Support for Scientific Applications

    Directory of Open Access Journals (Sweden)

    John B. Carter

    1999-01-01

    Full Text Available Impulse is a new memory system architecture that adds two important features to a traditional memory controller. First, Impulse supports application‐specific optimizations through configurable physical address remapping. By remapping physical addresses, applications control how their data is accessed and cached, improving their cache and bus utilization. Second, Impulse supports prefetching at the memory controller, which can hide much of the latency of DRAM accesses. Because it requires no modification to processor, cache, or bus designs, Impulse can be adopted in conventional systems. In this paper we describe the design of the Impulse architecture, and show how an Impulse memory system can improve the performance of memory‐bound scientific applications. For instance, Impulse decreases the running time of the NAS conjugate gradient benchmark by 67%. We expect that Impulse will also benefit regularly strided, memory‐bound applications of commercial importance, such as database and multimedia programs.

  19. Prevalence and correlates of bipolar disorders in patients with eating disorders.

    Science.gov (United States)

    Tseng, Mei-Chih Meg; Chang, Chin-Hao; Chen, Kuan-Yu; Liao, Shih-Cheng; Chen, Hsi-Chung

    2016-01-15

    To investigate the prevalence and correlates of bipolar disorders in patients with eating disorders (EDs), and to examine differences in effects between major depressive disorder and bipolar disorder on these patients. Sequential attendees were invited to participate in a two-phase survey for EDs at the general psychiatric outpatient clinics. Patients diagnosed with EDs (n=288) and controls of comparable age, sex, and educational level (n=81) were invited to receive structured interviews for psychiatric co-morbidities, suicide risks, and functional level. All participants also completed several self-administered questionnaires assessing general and eating-related pathology and impulsivity. Characteristics were compared between the control, ED-only, ED with major depressive disorder, and ED with bipolar disorder groups. Patients with all ED subtypes had significantly higher rates of major depressive disorder (range, 41.3-66.7%) and bipolar disorder (range, 16.7-49.3%) than controls did. Compared to patients with only EDs, patients with comorbid bipolar disorder and those with comorbid major depressive disorder had significantly increased suicidality and functional impairments. Moreover, the group with comorbid bipolar disorder had increased risks of weight dysregulation, more impulsive behaviors, and higher rates of psychiatric comorbidities. Participants were selected in a tertiary center of a non-Western country and the sample size of individuals with bipolar disorder in some ED subtypes was small. Bipolar disorders were common in patients with EDs. Careful differentiation between bipolar disorder and major depressive disorder in patients with EDs may help predict associated psychopathology and provide accurate treatment. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Contribution of Impulsivity and Serotonin Receptor Neuroadaptations to the Development of an MDMA ('Ecstasy') Substance Use Disorder.

    Science.gov (United States)

    Schenk, Susan; Aronsen, Dane

    As is the case with other drugs of abuse, a proportion of ecstasy users develop symptoms consistent with a substance use disorder (SUD). In this paper, we propose that the pharmacology of MDMA, the primary psychoactive component of ecstasy tablets, changes markedly with repeated exposure and that neuroadaptations in dopamine and serotonin brain systems underlie the shift from MDMA use to MDMA misuse in susceptible subjects. Data from both the human and laboratory animal literature are synthesized to support the idea that (1) MDMA becomes a less efficacious serotonin releaser and a more efficacious dopamine releaser with the development of behaviour consistent with an SUD and (2) that upregulated serotonin receptor mechanisms contribute to the development of the MDMA SUD via dysregulated inhibitory control associated with the trait of impulsivity.

  1. Impaired decisional impulsivity in pathological videogamers.

    Directory of Open Access Journals (Sweden)

    Michael A Irvine

    Full Text Available Pathological gaming is an emerging and poorly understood problem. Impulsivity is commonly impaired in disorders of behavioural and substance addiction, hence we sought to systematically investigate the different subtypes of decisional and motor impulsivity in a well-defined pathological gaming cohort.Fifty-two pathological gaming subjects and age-, gender- and IQ-matched healthy volunteers were tested on decisional impulsivity (Information Sampling Task testing reflection impulsivity and delay discounting questionnaire testing impulsive choice, and motor impulsivity (Stop Signal Task testing motor response inhibition, and the premature responding task. We used stringent diagnostic criteria highlighting functional impairment.In the Information Sampling Task, pathological gaming participants sampled less evidence prior to making a decision and scored fewer points compared with healthy volunteers. Gaming severity was also negatively correlated with evidence gathered and positively correlated with sampling error and points acquired. In the delay discounting task, pathological gamers made more impulsive choices, preferring smaller immediate over larger delayed rewards. Pathological gamers made more premature responses related to comorbid nicotine use. Greater number of hours played also correlated with a Motivational Index. Greater frequency of role playing games was associated with impaired motor response inhibition and strategy games with faster Go reaction time.We show that pathological gaming is associated with impaired decisional impulsivity with negative consequences in task performance. Decisional impulsivity may be a potential target in therapeutic management.

  2. I can't wait: Methods for measuring and moderating individual differences in impulsive choice.

    Science.gov (United States)

    Peterson, Jennifer R; Hill, Catherine C; Marshall, Andrew T; Stuebing, Sarah L; Kirkpatrick, Kimberly

    2015-01-01

    Impulsive choice behavior occurs when individuals make choices without regard for future consequences. This behavior is often maladaptive and is a common symptom in many disorders, including drug abuse, compulsive gambling, and obesity. Several proposed mechanisms may influence impulsive choice behavior. These mechanisms provide a variety of pathways that may provide the basis for individual differences that are often evident when measuring choice behavior. This review provides an overview of these different pathways to impulsive choice, and the behavioral intervention strategies being developed to moderate impulsive choice. Because of the compelling link between impulsive choice behavior and the near-epidemic pervasiveness of obesity in the United States, we focus on the relationship between impulsive choice behavior and obesity as a test case for application of the multiple pathways approach. Choosing immediate gratification over healthier long term food choices is a contributing factor to the obesity crisis. Behavioral interventions can lead to more self controlled choices in a rat pre-clinical model, suggesting a possible gateway for translation to human populations. Designing and implementing effective impulsive choice interventions is crucial to improving the overall health and well-being of impulsive individuals.

  3. Impulsive compulsive behaviors in Japanese Parkinson's disease patients and utility of the Japanese version of the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's disease.

    Science.gov (United States)

    Tanaka, Kenichiro; Wada-Isoe, Kenji; Nakashita, Satoko; Yamamoto, Mikie; Nakashima, Kenji

    2013-08-15

    In order to evaluate impulsive compulsive behaviors (ICBs), such as pathological gambling, compulsive sexual behavior, compulsive buying, compulsive eating, punding, and dopamine dysregulation syndrome (DDS) in Japanese Parkinson's disease (PD) patients, we constructed a Japanese version of the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's disease (J-QUIP) and evaluated the utility of the J-QUIP in Japanese PD patients. J-QUIP was administered to 121 PD patients. Diagnoses of ICBs were made via interview of patients or their caregivers. Subsequently, in order to evaluate risk factors related to these conditions, we evaluated demographic and clinical characteristics, clinical features, and medications utilized. We were able to administer the J-QUIP to 118 of 121 PD patients (97.5%). Sensitivity and specificity of J-QUIP were similar to that reported for the original version of QUIP. In our study, the actual prevalence of each disorder diagnosed via interview was as follows: pathological gambling (6.5%), compulsive sexual behavior (3.2%), compulsive buying (3.2%), compulsive eating (3.2%), punding (6.5%), and DDS (2.2%). Significantly risk factors for these conditions were younger age (p=0.047), earlier age of disease onset (p=0.015), longer PD duration (p=0.001), total levodopa equivalent dose (p=0.006), and dosage of levodopa (p=0.019). We evaluated the prevalence of ICBs in Japanese PD patients along with factors associated with these behaviors via J-QUIP. Copyright © 2013 Elsevier B.V. All rights reserved.

  4. Impulsivity-related traits distinguish women with co-occurring bulimia nervosa in a psychiatric sample.

    Science.gov (United States)

    Reas, Deborah L; Pedersen, Geir; Rø, Øyvind

    2016-12-01

    This study investigated impulsivity-related personality traits using the Revised NEO Personality Inventory (NEO PI-R) in women diagnosed with co-occurring bulmia nervosa and borderline personality disorder (BN-BPD), borderline personality disorder (BPD no-BN), or major depressive disorder (MDD-only). The sample included 672 adult female admissions to a psychiatric day hospital treatment program. The NEO PI-R facets of impulsiveness (N5), excitement-seeking (E5), self-discipline (C5), and deliberation (C6) provided a proxy assessment of impulsivity-related traits tapping negative urgency, sensation-seeking, lack of perseverance, and lack of premeditation/planning. After adjusting for age, BN-BPD displayed significantly higher levels of negative urgency and lack of premeditation than BPD without co-occurring BN. Women with BN-BPD also had significantly higher levels of impulsivity traits than MDD across domains, except for lack of perseverance. Impulsivity-related traits of negative urgency and lack of premeditation significantly differentiated women with versus without co-occurring BN among women with borderline personality disorder. Lower levels of impulsivity-related traits in women with MDD indicated that effects were not simply attributable to any form of psychopathology. Of the impulsivity traits, negative urgency demonstrated the strongest effect, providing further evidence of the important relationship between negative urgency and the expression of bulimic symptomology. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:1093-1096). © 2016 Wiley Periodicals, Inc.

  5. Impulsiveness, overactivity, and poorer sustained attention improve by chronic treatment with low doses of l-amphetamine in an animal model of Attention-Deficit/Hyperactivity Disorder (ADHD).

    Science.gov (United States)

    Sagvolden, Terje

    2011-03-30

    ADHD is currently defined as a cognitive/behavioral developmental disorder where all clinical criteria are behavioral. Overactivity, impulsiveness, and inattentiveness are presently regarded as the main clinical symptoms. There is no biological marker, but there is considerable evidence to suggest that ADHD behavior is associated with poor dopaminergic and noradrenergic modulation of neuronal circuits that involve the frontal lobes. The best validated animal model of ADHD, the Spontaneously Hypertensive Rat (SHR), shows pronounced overactivity, impulsiveness, and deficient sustained attention. The primary objective of the present research was to investigate behavioral effects of a range of doses of chronic l-amphetamine on ADHD-like symptoms in the SHR. The present study tested the behavioral effects of 0.75 and 2.2 mg l-amphetamine base/kg i.p. in male SHRs and their controls, the Wistar Kyoto rat (WKY). ADHD-like behavior was tested with a visual discrimination task measuring overactivity, impulsiveness and inattentiveness. The striking impulsiveness, overactivity, and poorer sustained attention seen during baseline conditions in the SHR were improved by chronic treatment with l-amphetamine. The dose-response curves were, however, different for the different behaviors. Most significantly, the 0.75 mg/kg dose of l-amphetamine improved sustained attention without reducing overactivity and impulsiveness. The 2.2 mg/kg dose improved sustained attention as well as reduced SHR overactivity and impulsiveness. The effects of l-amphetamine to reduce the behavioral symptoms of ADHD in the SHR were maintained over the 14 days of daily dosing with no evidence of tolerance developing.

  6. Randomized Controlled Trial of Web-Based Psychoeducation for Women With Borderline Personality Disorder.

    Science.gov (United States)

    Zanarini, Mary C; Conkey, Lindsey C; Temes, Christina M; Fitzmaurice, Garrett M

    2017-07-11

    To determine if internet-based psychoeducation for borderline personality disorder is effective in reducing symptom severity and improving psychosocial functioning. Eighty women who met DSM-IV criteria for borderline personality disorder were randomly assigned either to the internet-based psychoeducation treatment group (n = 40) or to the internet-based control group with no psychoeducation (n = 40). Recruitment was conducted from July 2013 to March 2015. Subjects participated in 15 assessment periods that were divided into an acute phase (weeks 1-12) and a maintenance phase (months 6, 9, and 12). Main outcomes were assessed using the Zanarini Rating Scale for Borderline Personality Disorder. In the acute phase, women in the treatment group were found to have a significant decline in their scores on all 10 outcomes studied, while women in the control group had a significant decline on 7 of these outcomes. Two between-group differences were found to be significant-those in the treatment group reported a significantly greater decline in their impulsivity (z = -1.98, P = .048) and a significantly greater increase in their psychosocial functioning (z = -1.97, P = .049) than those in the control group. In the maintenance phase, those in the treatment group were found to have a significant decline in their scores on 9 of the 10 outcomes studied, while those in the control group had a significant decline in 3 of these outcomes. In terms of between-group differences, those in the treatment group reported a significantly greater decline in all 5 studied areas of borderline psychopathology: affective symptoms (z = -2.31, P = .021), cognitive symptoms (z = -3.20, P = .001), impulsivity (z = -2.44, P = .015), interpersonal difficulties (z = -2.15, P = .032), and overall borderline personality disorder symptoms (z = -2.11, P = .035). Taken together, these results suggest that internet-based psychoeducation is an effective form of early treatment for reducing the symptom

  7. Characteristic Risk Factors Associated with Planned versus Impulsive Suicide Attempters.

    Science.gov (United States)

    Kim, Jaeha; Lee, Kang-Sook; Kim, Dai Jin; Hong, Seung-Chul; Choi, Kyoung Ho; Oh, Youngmin; Wang, Sheng-Min; Lee, Hae-Kook; Kweon, Yong-Sil; Lee, Chung Tai; Lee, Kyoung-Uk

    2015-12-31

    The present study aimed to investigate predictors for planned suicide attempters. This study included 1,003 patients who attempted suicide and visited emergency department. They were divided into two groups, planned suicide attempters (SAs; n=133 [13.3%]) and impulsive SAs (n=870, [86.7%]), and the demographic variables, clinical characteristics, factors related to suicide, and psychiatric resources of the groups were compared. Major depressive disorder and substance use disorders were more common among planned SAs than among impulsive SAs. Additionally, the planned SAs were older, more likely to be divorced, separated or widowed, and more likely to have comorbid medical illnesses, severe depression, higher suicidality, and self-blaming tendencies than the impulsive SAs. Financial problems and physical illnesses were more common in planned SAs but interpersonal conflicts were more frequent in impulsive SAs. Planned SAs had fewer previous suicide attempts but these were more serious suicide attempts. The presence of the hope to die, a written will, and suicidal ideation of a repetitive, intense, and continuous nature were predictive of planned SAs. The present findings demonstrated that planned SAs had more severe psychopathology and medical illnesses than impulsive SAs. Therefore, screening for depression, substance use disorders, and suicidal plans among old and medically ill patients may be important for preventing suicide attempts.

  8. Sex differences in impulsive and compulsive behaviors: a focus on drug addiction.

    Science.gov (United States)

    Fattore, Liana; Melis, Miriam

    2016-09-01

    Sex differences in inhibition and self-regulation at a behavioral level have been widely described. From an evolutionary point of view, the different selection pressures placed on male and female hominids led them to differ in their behavioral strategies that allowed our species to survive during natural selection processes. These differences reflect changes in neural and structural plasticity that might be the core of sex differences, and of the susceptibility towards one psychiatric condition rather than another. The goal of the present review is to summarize current evidence for such a dichotomy in impulsive and compulsive behavior with a focus on drug addiction. Sex-dependent differences in drug abuse and dependence will be examined in the context of pathophysiological regulation of impulse and motivation by neuromodulators (i.e. gonadal hormones) and neurotransmitters (i.e. dopamine). Advances in the understanding of the sex differences in the capability to control impulses and motivational states is key for the determination of efficacious biologically based intervention and prevention strategies for several neuropsychiatric disorders where loss of impulse control and compulsivity are the core symptoms. © 2016 Society for the Study of Addiction.

  9. Decision making, impulse control and loss of willpower to resist drugs: a neurocognitive perspective.

    Science.gov (United States)

    Bechara, Antoine

    2005-11-01

    Here I argue that addicted people become unable to make drug-use choices on the basis of long-term outcome, and I propose a neural framework that explains this myopia for future consequences. I suggest that addiction is the product of an imbalance between two separate, but interacting, neural systems that control decision making: an impulsive, amygdala system for signaling pain or pleasure of immediate prospects, and a reflective, prefrontal cortex system for signaling pain or pleasure of future prospects. After an individual learns social rules, the reflective system controls the impulsive system via several mechanisms. However, this control is not absolute; hyperactivity within the impulsive system can override the reflective system. I propose that drugs can trigger bottom-up, involuntary signals originating from the amygdala that modulate, bias or even hijack the goal-driven cognitive resources that are needed for the normal operation of the reflective system and for exercising the willpower to resist drugs.

  10. Family routine moderates the relation between child impulsivity and oppositional defiant disorder symptoms.

    Science.gov (United States)

    Lanza, H Isabella; Drabick, Deborah A G

    2011-01-01

    Although child impulsivity is associated with oppositional defiant disorder (ODD) symptoms, few studies have examined whether family processes moderate this association. To address this gap, we tested whether child-reported family routine moderated the relation between child hyperactivity/impulsivity (HI) and ODD symptoms among a sample of low-income, urban, ethnic-minority children (N = 87, 51% male). Child HI and ODD symptoms were assessed using parent and teacher reports. HI also was indexed by a laboratory task. Family routine was assessed using child self-report. Hierarchical regression analyses indicated that family routine moderated child HI. Among children with higher levels of teacher-reported HI symptoms, lower levels of family routine were associated with higher levels of teacher-reported ODD symptoms compared to children with lower levels of teacher-reported HI symptoms. Children who self-reported higher levels of family routine were rated as low on teacher-reported ODD symptoms, regardless of teacher-reported HI levels. Parent report and laboratory measures of child HI did not produce significant interactions. Lower levels of family routine may confer risk for ODD symptoms among low-income, urban, ethnic-minority children experiencing higher levels of HI.

  11. Insight into the relationship between impulsivity and substance abuse from studies using animal models.

    Science.gov (United States)

    Winstanley, Catharine A; Olausson, Peter; Taylor, Jane R; Jentsch, J David

    2010-08-01

    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.

  12. A review of gambling disorder and substance use disorders

    OpenAIRE

    Rash CJ; Weinstock J; Van Patten R

    2016-01-01

    Carla J Rash,1 Jeremiah Weinstock,2 Ryan Van Patten2 1Calhoun Cardiology Center – Behavioral Health, UConn Health, Farmington, CT, USA; 2Department of Psychology, Saint Louis University, St Louis, MO, USA Abstract: In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), gambling disorder was recategorized from the “Impulse Control Disorder” section to the newly expanded “Substance-related and Addictive Disorders&r...

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

    Science.gov (United States)

    Patock-Peckham, Julie A; Morgan-Lopez, Antonio A

    2006-06-01

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

  14. Self-reported impulsivity in Huntington's disease patients and relationship to executive dysfunction and reward responsiveness.

    Science.gov (United States)

    Johnson, Patricia L; Potts, Geoffrey F; Sanchez-Ramos, Juan; Cimino, Cynthia R

    2017-09-01

    Few studies have directly investigated impulsivity in Huntington's disease (HD) despite known changes in dopaminergic and frontal functioning, changes that have been associated with impulsivity in other disorders and in the normal population. This study sought to further categorize impulsivity in HD through examining differences in self-reported impulsivity between community controls and HD patients, the relationship between executive dysfunction and impulsivity, and the relationship of a reward/punishment behavioral inhibit