An Investigation of Alternative Factor Models of Impulsivity using the UPPS-P.

The UPPS-P measures impulsivity as a five-factor construct (lack of premeditation, lack of perseverance, positive urgency, negative urgency and sensation seeking). Drawing on a number of theoretical considerations and alternative conceptions of impulsivity, the current study used confirmatory factor analysis (N = 1635) and multiple regression to evaluate and test alternative models comprising three, five, and a hierarchical model containing latent factors. The five factor and hierarchical models were shown to be valid and of near identical fit, whereas the three-factor model fit the data poorly. The current findings suggest that both the five factor and hierarchical models are useful applications of the UPPS-P. Depending on the purpose of future research, both models demonstrate utility in both risk assessment and treatment development. Multiple regression analysis revealed that positive urgency predicted problem gambling, which supports the predictive utility of impulsivity as a five-factor construct. While the latent factors of the hierarchical model are consistent with emerging theory, those using the UPPS-P should not overlook the unique contributions of the five factors. As the current study found meaningful predictive distinctions between positive and negative urgency, utilizing all five factors may increase measurement sensitivity and predictive utility.

The Psychology of Shoplifting: Development of a New Typology for Repeated Shoplifting.

Despite the damaging effects of shoplifting on individuals, the current literature offers little guidance for changing shoplifting behavior. One limitation in this area of research has been the failure to use empirically and theoretically sound methodologies to identify individuals' diverse characteristics and motivations. The present study addressed these limitations by developing an empirically and theoretically supported typology of the varied individuals who shoplift. Participants included 202 community individuals who reported repeated shoplifting and provided information about their shoplifting behavior, motivations, mental health, ethical attitudes, personal histories, and life circumstances. Cluster analyses revealed that the sample could be divided into six discrete groups. These clusters comprise a typology of shoplifting, including Loss-Reactive (28% of the sample), Impulsive (20%), Depressed (18%), Hobbyist (18%), Addictive-Compulsive (9%), and Economically Disadvantaged (7%) types. Each type comprises a unique pattern of shoplifting with unique needs. This research establishes a promising foundation for treating the diverse individuals who shoplift.

Kleptomania or common theft - diagnostic and judicial difficulties. / Kleptomania czy kradziez pospolita ­ trudnosci diagnostyczno-orzecznicze.

First descriptions of kleptomania as a mental disorder date back to the nineteenth century. For the first time, kleptomania as an accompanying symptom rather than a formal diagnosis was included in the classification of psychiatric disorders of the American Psychiatric Association DSM-I in 1952. It was included in the International Classification of Diseases ICD-10 and classified under "habit and impulse disorders". Kleptomania is a serious disorder, as numerous thefts are impulsively carried out, carrying the risk of detection and consequently criminal liability. In Poland, we lack epidemiological data, however, it is estimated that 5% of those who commit theft are affected by kleptomania. People suffering from this disorder often do not seek a medical opinion so reviewing such cases is challenging for expert psychiatrists. The authors have proposed the term "kleptomania spectrum" for defining cases in which patients have an intense urge to steal, experienced a sense of tension from such an action, and relief following it, however, the criterion of theft of a superfluous object, without a profitable motive for themselves or others is not met.

Dimensional conceptualizations of impulsivity.

Impulsivity is a transdiagnostic dimension of crucial importance to understanding psychopathology, as it is highly relevant to a wide array of maladaptive life outcomes including substance use, criminality, and other risky behaviors. There exist a variety of operationalizations of impulsivity across the literature distinct nomological networks. In fact, research suggests that "impulsivity" is a multifaceted construct comprised of at least 4 distinct traits that have unique pathways to maladaptive behaviors. Those traits are positive and negative urgency, sensation seeking, premeditation, and perseverance. Thus, it is crucial that any diagnostic system, or model of maladaptive traits, capture the nuances among these impulsigenic traits. The present study investigated the conceptualization of impulsigenic traits within the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013). Alternative personality disorder model and an alternative trait model to determine how well they captured these variants. This study obtained questionnaire ratings and behavioral task data from 450 community-dwelling adults oversampled for a history of involvement in the legal and/or mental health systems. The results showed that although the DSM-5 trait model captures well a broad conceptualization of impulsivity, some lower-order facets lack specificity. (PsycINFO Database Record

Latent traits of impulsivity and compulsivity: toward dimensional psychiatry.

BACKGROUND: The concepts of impulsivity and compulsivity are commonly used in psychiatry. Little is known about whether different manifest measures of impulsivity and compulsivity (behavior, personality, and cognition) map onto underlying latent traits; and if so, their inter-relationship. METHODS: A total of 576 adults were recruited using media advertisements. Psychopathological, personality, and cognitive measures of impulsivity and compulsivity were completed. Confirmatory factor analysis was used to identify the optimal model. RESULTS: The data were best explained by a two-factor model, corresponding to latent traits of impulsivity and compulsivity, respectively, which were positively correlated with each other. This model was statistically superior to the alternative models of their being one underlying factor ('disinhibition') or two anticorrelated factors. Higher scores on the impulsive and compulsive latent factors were each significantly associated with worse quality of life (both p < 0.0001). CONCLUSIONS: This study supports the existence of latent functionally impairing dimensional forms of impulsivity and compulsivity, which are positively correlated. Future work should examine the neurobiological and neurochemical underpinnings of these latent traits; and explore whether they can be used as candidate treatment targets. The findings have implications for diagnostic classification systems, suggesting that combining categorical and dimensional approaches may be valuable and clinically relevant.

Toward a theory of distinct types of "impulsive" behaviors: A meta-analysis of self-report and behavioral measures.

Impulsivity is considered a personality trait affecting behavior in many life domains, from recreational activities to important decision making. When extreme, it is associated with mental health problems, such as substance use disorders, as well as with interpersonal and social difficulties, including juvenile delinquency and criminality. Yet, trait impulsivity may not be a unitary construct. We review commonly used self-report measures of personality trait impulsivity and related constructs (e.g., sensation seeking), plus the opposite pole, control or constraint. A meta-analytic principal-components factor analysis demonstrated that these scales comprise 3 distinct factors, each of which aligns with a broad, higher order personality factor-Neuroticism/Negative Emotionality, Disinhibition versus Constraint/Conscientiousness, and Extraversion/Positive Emotionality/Sensation Seeking. Moreover, Disinhibition versus Constraint/Conscientiousness comprise 2 correlated but distinct subfactors: Disinhibition versus Constraint and Conscientiousness/Will versus Resourcelessness. We also review laboratory tasks that purport to measure a construct similar to trait impulsivity. A meta-analytic principal-components factor analysis demonstrated that these tasks constitute 4 factors (Inattention, Inhibition, Impulsive Decision-Making, and Shifting). Although relations between these 2 measurement models are consistently low to very low, relations between both trait scales and laboratory behavioral tasks and daily-life impulsive behaviors are moderate. That is, both independently predict problematic daily-life impulsive behaviors, such as substance use, gambling, and delinquency; their joint use has incremental predictive power over the use of either type of measure alone and furthers our understanding of these important, problematic behaviors. Future use of confirmatory methods should help to ascertain with greater precision the number of and relations between impulsivity-related components.

Compulsivity, impulsivity, and the DSM-5 process.

Compulsivity and impulsivity are cross-cutting, dimensional symptom domains that span traditional diagnostic boundaries. We examine compulsivity and impulsivity from several perspectives and present implications for these symptom domains as they relate to classification. We describe compulsivity and impulsivity as general concepts, from the perspectives of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) Research Planning Agenda, and from the DSM-5 workgroups, literature reviews, and field trials. Finally, we detail alternative modes of classification for compulsivity and impulsivity in line with the Research Domain Criteria (RDoC) and International Classification of Diseases (ICD-11).

Distinguishing Personality Psychopathology Five (PSY-5) characteristics associated with violent and nonviolent juvenile delinquency.

This study examined the relationship between the Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A) Personality Psychopathology Five (PSY-5) scales and violent and nonviolent juvenile delinquency. Participants were 260 adolescent boys and girls in a forensic setting. Results indicated that Disconstraint (DISC), a marker of behavioral disinhibition and impulsivity, was associated with nonviolent delinquency, whereas Aggressiveness (AGGR), which is characterized by the use of instrumental aggression and interpersonal dominance, was specifically associated with violent delinquency. These findings are consistent with expectations based on empirical findings in the broader personality literature linking the construct of disinhibition with externalizing psychopathology as well as the literature identifying callous-unemotional aggression as a risk factor for violence.

Different subtypes of impulsivity differentiate uncontrolled eating and dietary restraint.

The current study explored the relationship between three subtypes of impulsivity (Reflection Impulsivity, Impulsive Choice, and Impulsive Action) and measures of uncontrolled eating (TFEQ-D) and restraint (TFEQ-R). Eighty women classified as scoring higher or lower on TFEQ-D and TFEQ-R completed the Matching Familiar Figures Test (MFFT20), Delay Discounting Task (DDT), a Go No Go task, Balloon Analogue Risk Task (BART), and the Barrett Impulsivity Scale-11 (BIS-11). To test whether these relationships were affected by enforced controls overeating, half of the participants fasted the night before and ate breakfast in the laboratory before testing and half had no such control. Women scoring higher on the TFEQ-D were significantly more impulsive on the MFFT20 and BIS-11 overall but not on DDT, Go No Go or BART. Women scoring higher on TFEQ-R were significantly less impulsive on the Go No Go task but did not differ on other measures. The eating manipulation modulated responses on the BART and BIS-11 non-planning scale depending on TFEQ-D classification. These results confirm recent data that high scores on TFEQ-D are related to impulsivity, but imply this relates more to Reflection Impulsivity rather than Impulsive Choice or Action. In contrast restrained eating was associated with better inhibitory control. Taken together, these results suggest that subtypes of impulsivity further differentiate uncontrolled eating and restraint, and suggest that a poor ability to reflect on decisions may underlie some aspects of overeating.

Investigating a socially anxious-impulsive subgroup of adolescents: a prospective community study.

Previous research has identified a subgroup of socially anxious adults who are both anxious and impulsive. To date, however, this subgroup has not been identified in adolescence. Therefore, in this study we aimed to identify this subgroup in a sample of adolescents. In addition, we hypothesized that this subgroup would be higher on problem behaviors, and that these processes would be moderated by gender. We used longitudinal data from 714 adolescents who were in the 7th and 8th grades at Time 1. They were followed annually for three years. Cluster analyses identified an anxious-inhibited subgroup as well as an anxious-impulsive subgroup in early adolescence (Time 1). The socially anxious-impulsive adolescent boys were generally higher on both intoxication frequency and delinquency compared with all other adolescents in all clusters at each time point. Findings suggest that social anxiety subgroups may differ on problem behavior, and that early detection of an anxious-impulsive subgroup may be important to prevent maladjustment, especially for adolescent boys.

Psychopathy-related personality traits and shame management strategies in adolescents.

The purpose of this study was to examine whether there is a correlation between the amount of psychopathy-related personality traits and the type of shame management in adolescents. Two hypotheses were examined; first, that there is a positive correlation between psychopathy-related personality traits and more unconscious and externalized shame management strategies, and second, that there is a negative correlation between psychopathy-related personality traits and more conscious and internalized shame management strategies. Gender differences were also examined. In total, 236 participants were available for the study. All were secondary-level students, aged 16 to 21 years. Of these, 196 were examined: 96 were male and 100 female. The study used two self-assessment forms-the Youth Psychopathic traits Inventory (YPI) and the Compass of Shame Scale (CoSS)-to measure the relevant personality characteristics. The results indicated gender differences, which led to all the analyses being conducted separately for males and females. Support was found for the study's first hypothesis, but not for the second, which was true for both males and females. Our results may have implications for the treatment of adolescents with a high percentage of psychopathy-related personality traits; they also indicate the need for more research on the association between psychopathy and shame management.

Impulsivity and the modular organization of resting-state neural networks.

Impulsivity is a complex trait associated with a range of maladaptive behaviors, including many forms of psychopathology. Previous research has implicated multiple neural circuits and neurotransmitter systems in impulsive behavior, but the relationship between impulsivity and organization of whole-brain networks has not yet been explored. Using graph theory analyses, we characterized the relationship between impulsivity and the functional segregation ("modularity") of the whole-brain network architecture derived from resting-state functional magnetic resonance imaging (fMRI) data. These analyses revealed remarkable differences in network organization across the impulsivity spectrum. Specifically, in highly impulsive individuals, regulatory structures including medial and lateral regions of the prefrontal cortex were isolated from subcortical structures associated with appetitive drive, whereas these brain areas clustered together within the same module in less impulsive individuals. Further exploration of the modular organization of whole-brain networks revealed novel shifts in the functional connectivity between visual, sensorimotor, cortical, and subcortical structures across the impulsivity spectrum. The current findings highlight the utility of graph theory analyses of resting-state fMRI data in furthering our understanding of the neurobiological architecture of complex behaviors.

Are DSM-IV-TR borderline personality disorder, ICD-10 emotionally unstable personality disorder, and CCMD-III impulsive personality disorder analogous diagnostic categories across psychiatric nomenclatures?

This study examined the validity of the borderline construct which encompasses diagnostic criteria from the DSM-IV-TR Borderline Personality Disorder (BPD), ICD-10 Emotionally Unstable Personality Disorder (EUPD), and CCMD-III Impulsive Personality Disorder (IPD) in a sample of 1,419 Chinese psychiatric patients. Participants completed the Chinese Personality Disorder Inventory and the Chinese Personality Assessment Inventory-2 assessing various disordered personality features. Adequate internal consistency was found for the borderline construct (α = .83). Exploratory factor analysis revealed two components: (1) affective and cognitive disturbances, and (2) impulse dysregulation, which were replicated by confirmatory factor analysis. Item analysis indicated that the various borderline criteria displayed similar levels of diagnostic efficiency, which does not support the elimination of fear of abandonment and transient psychotic features from the EUPD and IPD criteria set. Findings of this study suggest that BPD, EUPD, and IPD may represent analogous diagnostic categories across classification systems.

The latent classes of subclinical ADHD symptoms: convergences of multiple informant reports.

The purpose of the present study was to conduct latent class analysis on the Hyperactivity scale of the Strengths and Difficulties Questionnaire in order to identify distinct subgroups of subclinical ADHD in a multi-informant framework. We hypothesized a similar structure between teachers and parents, and differences in symptom severity across latent classes. Data was collected from a non-referred sample of children aged 8-13 years. We performed latent class analyses on parent (n = 383) and teacher (n = 391) ratings of the Hyperactivity scale items from both versions of the questionnaire. Those children who had ratings from both informants (n = 272) were included in the cross-informant analyses, in which the similar or equivalent classes across raters were determined. A three-class solution for parent report and a five-class solution for teacher report emerged in the subsample of boys. For girls, a three-class structure for parents and a four-class structure for teachers were optimal. Besides non-symptomatic groups, mild and severe combined classes, mild inattentive-impulsive classes, and among boys, a mild hyperactive-impulsive class was obtained. The cross-informant analyses demonstrated that quite similar subgroups were detached regardless of informant; however, the teacher classes were somewhat more elaborated. The results are in line with the previous latent class analytic studies, and support the combination of dimensional and categorical approaches. The importance of milder symptoms and sub-threshold ADHD categories are emphasized for the fields of neuropsychology, neuroscience, and education, as well as for diagnosis and personalized treatment.

The criterion validity of the Borderline Personality Features Scale for Children in an adolescent inpatient setting.

The purpose of the current study was to examine the criterion validity of the Borderline Personality Features Scale for Children (BPFS-C) by assessing the performance of the self-report and a newly developed parent report version of the measure (BPFS-P) in detecting a borderline personality disorder (BPD) diagnosis in adolescent inpatients. This study also examined parent-child agreement and the internal consistency of the BPFS subscales. An inpatient sample of adolescents (n = 51) ranging from ages 12-18 completed the BPFS and were administered the Child Interview for DSM-IV Borderline Personality Disorder (CI-BPD) by trained clinical research staff. ROC analyses revealed that the BPFS-C has high accuracy (AUC = .931; Se = .856; Sp = .840) in discriminating adolescents with a diagnosis of BPD, as measured by the CI-BPD, while the BPFS-P has moderate accuracy (AUC = .795; Se = .733; Sp = .720). Parent-child agreement on total scores was significant (r = .687; p < .005). Cronbach's alphas suggested internal consistency for the four subscales of the BPFS. These findings support the criterion validity of this measure, particularly the self-report version, in adolescent inpatient settings.

Impulsivity and risk-taking in co-occurring psychotic disorders and substance abuse.

Impulsivity is a risk-factor associated with substance use disorders. On paper-and-pencil measures, people with comorbid psychotic disorders and substance abuse have been shown to be more impulsive than their non-using counterparts. However, there has been little research on the behavioral components that, collectively, define the construct of impulsivity, which have been identified as: temporal discounting, risk taking, underestimating time, and failure to inhibit extraneous responding. This study compared people with psychotic disorders who did and did not use cocaine on behavioral measures of these components. One group (COC-now) had a positive urine drug screen (UDS) for cocaine (N=20). A second group (COC-past) had a negative UDS, but a positive cocaine history (N=20). Finally, the third group (control) had no history of cocaine use (N=20). Those with a current or past history of cocaine use engaged in more risk-taking behaviors and seemed to be less affected by anticipated loss and more attuned to monetary gains. However, contrary to our hypothesis, patients in the COC-now group selected larger, delayed rewards over the smaller, immediate rewards. Performance on the immediate/delay task also suggested greater attentiveness to the magnitude of the monetary reward for patients with a positive UDS.

New ways to classify bipolar disorders: going from categorical groups to symptom clusters or dimensions.

Current psychiatric disorder classifications are based exclusively on categorical models, which were designed to increase the reliability of diagnoses. However, this system has some limitations, and various psychiatric disorders may be classified using a dimensional approach, which is more appropriate when no clear boundaries exist between entities or when examining various features on a continuum. Thus, the forthcoming DSM-5 appears to be undertaking a hybrid approach by including categorical models associated with dimensions. We aim to review examples of dimensions or symptom clusters associated with a categorical approach that could be useful in refining bipolar disorder classification. We selected predominant polarity, psychotic symptoms, inhibition/activation behavioral level, and emotional reactivity to define mood episodes, impulsivity/suicidality/substance misuse, and cognitive impairment. The selection was based on the fact that these dimensions or symptom clusters are currently being discussed to be implemented in the DSM-5 and/or may orientate toward the choice of specific treatments and represent more homogeneous and thus more appropriate subgroups for research purposes. In the future, there will be a need to identify biomarkers that can definitively validate the use of these criteria.