[Trauma, developmental stages, and motivational abilities in indentured Swiss child laborers in old age]. / Traumata, Entwicklungsperioden und motivationale Fähigkeiten bei Schweizer Verdingkindern im Alter.

OBJECTIVES: The study examined the relationship between potential traumatic events in childhood and motivational abilities in old adulthood according to developmental stage. METHODS: The motivational abilities of self-efficacy, conscientiousness and impulsivity (self control) were investigated in a sample of 114 formerly indentured Swiss child laborers. Adversities were assessed by the Childhood Trauma Questionnaire (CTQ). The sample was split into four age groups according to the beginning of the potential trauma: infancy (0-2), preschool (3-5), early childhood (6-9), and early adolescence (≥ 10). RESULTS: The strongest relationship was found between self-efficacy and CTQ in the group "early adolescence," followed by the relationship between conscientiousness and CTQ in the same group. Impulsivity and CTQ were most strongly associated in the "preschool" group. CONCLUSION: Childhood adversities seem to have a negative impact on self-efficacy and conscientiousness after the age of ten. In contrast, self-control seems to be affected by the deleterious effect of trauma or adversity already at an earlier age.

Mindfulness training as an intervention for substance user incarcerated adolescents: a pilot grounded theory study.

Mindfulness-based treatment for adolescents is a clinical and research field still in its infancy. Literature is needed to address specific subcultural populations to expand this growing field. Further, minimal literature addresses the process of teaching mindfulness to adolescents. The current study investigated how to effectively teach mindfulness to 10 incarcerated adolescent substance users (N = 10) in an urban California detention setting. A grounded theory approach was used to collect and analyze interview data over a 1-year period during 2011 and 2012 in order to develop an initial theory for teaching mindfulness to incarcerated adolescent substance users. Implications, limitations, and future research are discussed.

Genetic modulation of personality traits: a systematic review of the literature.

The heritability of human personality traits is by now well established. However, since the first reports on associations between specific genetic variants and personality traits, only modest progress has been made in identifying loci that robustly support these associations. The aim of this study was to provide a summary of literature data on association studies focused on the genetic modulation of personality, according to the Cloninger, Eysenck and Costa and McCrae models. PubMed was searched for papers investigating the association between any gene variant and personality traits, which were grouped into five clusters: (a) anxiety, (b) impulsivity, (c) determination-activity, (d) socialization and (e) spirituality, in healthy individuals, populations and psychiatric patients. A total of 369 studies were included. No clear consensus on the role of any individual gene variant in personality modulation emerged, although SLC6A4 haplotypes and the DRD4 rs1800955 promoter variant seemed to be more reliably related to anxiety and impulsivity-related traits, respectively. Because conflicting results emerged from the literature, plausibly as a result of the combined influence of many loci of small effects on personality, larger sample sizes and more narrow and specific phenotype will be the minimum requirements for future genetic studies on personality. Moreover, gene × gene and gene × environment interaction studies deserve further attention.

The future is now: comparing the effect of episodic future thinking on impulsivity in lean and obese individuals.

The choice of small immediate rewards as opposed to larger delayed rewards, or delay discounting, is an important dimension of impulsive decision making. The inability to delay gratification is related to obesity, as well as other maladaptive behaviors such as substance abuse, problem drinking, smoking, pathological gambling, and risky HIV behaviors. One way to reduce delay discounting (DD) may be to use prospective imagery in the form of episodic future thinking (EFT) during inter-temporal decision making. We have recently shown that EFT reduces DD and ad libitum energy intake in obese individuals. However, no studies have examined whether the magnitude of the EFT effect differs between lean and overweight/obese individuals. We conducted a within-subject design experiment to compare the efficacy of EFT versus a control task in reducing DD between lean (N=24) and overweight/obese (N=24) women. Participants attended two sessions in which they engaged in either EFT or control episodic thinking during a DD task. We also examined whether individual differences such as trait time perspective, behavioral inhibition or behavioral activation moderated the EFT effect on DD. Results showed EFT reduced DD similarly for lean and overweight/obese individuals. The EFT effect was moderated by behavioral activation. This suggests EFT is just as effective in reducing impulsive decision making in obese individuals as it is in lean individuals and may be useful in reducing other impulsive obesity related behaviors.

Impulsivity, self-control, and hypnotic suggestibility.

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.

The role of impulsivity in relapse vulnerability.

Drug dependence in humans is often accompanied by behavioral disturbances such as maladaptive levels of impulsivity. In turn, there is accumulating evidence from preclinical laboratory animal and clinical studies indicating that impulsive behavior might be causally linked to several distinct processes in drug addiction, including the onset, maintenance and relapsing nature of drug use. This leads to the question as to whether pharmacological or behavioral approaches aimed at ameliorating impulsivity might prove effective therapeutic interventions in human drug dependence. This paper reviews evidence for an important role of impulsivity as a determinant of drug dependence with a particular focus on relapse vulnerability and addresses the implications of these findings for the clinical management of relapse prevention.

'Roid rage in rats? Testosterone effects on aggressive motivation, impulsivity and tyrosine hydroxylase.

In humans and animals, anabolic-androgenic steroids (AAS) increase aggression, but the underlying behavioral mechanisms are unclear. AAS may increase the motivation to fight. Alternatively, AAS may increase impulsive behavior, consistent with the popular image of 'roid rage. To test this, adolescent male rats were treated chronically with testosterone (7.5mg/kg) or vehicle and tested for aggressive motivation and impulsivity. Rats were trained to respond on a nose-poke on a 10 min fixed-interval schedule for the opportunity to fight in their home cage with an unfamiliar rat. Although testosterone increased aggression (6.3±1.3 fights/5 min vs 2.4±0.8 for controls, p<0.05), there was no difference in operant responding (28.4±1.6 nose-pokes/10 min for testosterone, 32.4±7.0 for vehicle). This suggests that testosterone does not enhance motivation for aggression. To test for impulsivity, rats were trained to respond for food in a delay-discounting procedure. In an operant chamber, one lever delivered one food pellet immediately, the other lever gave 4 pellets after a delay (0, 15, 30 or 45 s). In testosterone- and vehicle-treated rats, body weights and food intake did not differ. However, testosterone-treated rats chose the larger, delayed reward more often (4.5±0.7 times in 10 trials with 45 s delay) than vehicle controls (2.5±0.5 times, p<0.05), consistent with a reduction in impulsive choice. Thus, although chronic high-dose testosterone enhances aggression, this does not include an increase in impulsive behavior or motivation to fight. This is further supported by measurement of tyrosine hydroxylase (TH) by Western immunoblot analysis in brain regions important for motivation (nucleus accumbens, Acb) and executive function (medial prefrontal cortex, PFC). There were no differences in TH between testosterone- and vehicle-treated rats in Acb or PFC. However, testosterone significantly reduced TH (to 76.9±3.1% of controls, p<0.05) in the caudate-putamen, a brain area important for behavioral inhibition, motor control and habit learning.

Delay discounting in adults receiving treatment for marijuana dependence.

Delay discounting is an index of impulsive decision-making and reflects an individual's preference for smaller immediate rewards relative to larger delayed rewards. Multiple studies have indicated comparatively high rates of discounting among tobacco, alcohol, cocaine, and other types of drug users, but few studies have examined discounting among marijuana users. This report is a secondary analysis of data from a clinical trial that randomized adults with marijuana dependence to receive one of four treatments that involved contingency management (CM) and cognitive-behavioral therapy interventions. Delay discounting was assessed with the Experiential Discounting Task (Reynolds & Schiffbauer, 2004) at pretreatment in 93 participants and at 12 weeks posttreatment in 61 participants. Results indicated that higher pretreatment delay discounting (i.e., more impulsive decision-making) significantly correlated with lower readiness to change marijuana use (r = -0.22, p = .03) and greater number of days of cigarette use (r = .21, p = .04). Pretreatment discounting was not associated with any marijuana treatment outcomes. CM treatment significantly interacted with time to predict change in delay discounting from pre- to posttreatment; participants who received CM did not change their discounting over time, whereas those who did not receive CM significantly increased their discounting from pre- to posttreatment. In this sample of court-referred young adults receiving treatment for marijuana dependence, delay discounting was not strongly related to treatment outcomes, but there was some evidence that CM may protect against time-related increases in discounting.

Loudness dependence of auditory evoked potentials in patients with borderline personality disorder--impact of psychopathology.

Alterations of the central serotonergic system are considered to be involved in the pathophysiology of borderline personality disorder (BPD). The loudness dependence of the N1/P2 component of auditory evoked potentials (LD) has been shown to indirectly reflect central serotonergic activity. The aim of this study was to investigate LD in patients with BPD compared to healthy controls, and to evaluate the association between LD and psychopathology such as anxiety, anger or impulsiveness. Female patients with BPD were included and compared to age- and sex-matched healthy subjects. Self-rating instruments, such as the State-Trait Anxiety Inventory (STAI), State-Trait Anger Expression Inventory (STAXI), and the Barratt Impulsiveness Scale (BIS) were used to assess clinical scores of anxiety, anger, and impulsiveness. Evoked potentials were recorded following the application of acoustic stimuli with increasing intensities; the LD was analysed using dipole source analysis. The mean LD was significantly higher in patients with BPD compared to controls. In the entire sample there were significant positive correlations of LD with state anxiety scores and STAXI subscores. The data contribute to the knowledge of neurophysiological alterations in patients with BPD, supporting the hypothesis of serotonergic dysregulation in the pathophysiology of the disorder. The significant clinical correlations suggest monoaminergic modulations of psychopathology on the symptom level.

Escaping the impulse to immediate gratification: the prospect concept promotes a future-oriented mindset, prompting an inclination towards delayed gratification.

People's willingness to postpone receiving an immediate reward in order to gain additional benefits in the future, that is, a tendency to shallow delay discounting, is closely related to one's health, wealth, and happiness. We conducted two experiments investigating how the prospect concept can induce a future-oriented mindset and induce people to behave accordingly. We found that engaging in prospective imagery led the participants to focus on delayed utility over immediate utility in financial decisions (Experiment 1). Participants who received the prospect prime via a scrambled-sentence task decreased their desire to pursue hedonic activities for instant gratification (Experiment 2). Moreover, a state of future orientation mediated the effect of the prospect prime on measures of delayed gratification (Experiments 1 and 2). Thus, reminders of prospect may activate a mindset for future orientation by which delayed gratification is strengthened.

Delay discounting predicts adolescent substance abuse treatment outcome.

The purpose of the current study was to identify predictors of delay discounting among adolescents receiving treatment for marijuana abuse or dependence, and to test delay discounting as a predictor of treatment outcome. Participants for this study were 165 adolescents (88% male) between the ages of 12 and 18 (mean age = 15.8 years; standard deviation = 1.3 years) who enrolled in a clinical trial comparing three behavioral treatments for adolescent marijuana abuse or dependence. Participants completed a delay discounting task at treatment onset for $100 and $1,000 of hypothetical money and marijuana. Overall, smaller magnitude rewards were discounted more than larger magnitude rewards. Delay discounting rates were concurrently related to demographic variables (socioeconomic status, race). Delay discounting of $1,000 of money predicted during treatment abstinence outcomes among adolescent marijuana abusers, over and above the effects of type of treatment received. Teens who show higher levels of discounting of the future may be an important subgroup to identify at treatment onset. Youth with a greater tendency to discount the future may require different intervention strategies that address their impulsivity (e.g., targeting executive function or inhibitory control) and/or different schedules of reinforcement to address their degree of preference for immediate rewards.

Living in the here and now: interrelationships between impulsivity, mindfulness, and alcohol misuse.

RATIONALE: Impulsivity and mindfulness both emphasize orientation to the present, and both have been linked to alcohol misuse, but the relationship between the two is not clearly understood. OBJECTIVES: The objectives of this study are to examine the relationships between elements of impulsivity and mindfulness and to examine both variables in relation to alcohol misuse. METHOD: Young adults (N = 116) were assessed for alcohol use, mindfulness, and impulsivity using psychometrically validated measures. RESULTS: Numerous significant associations were present among the facets of impulsivity and mindfulness. All impulsivity facets and three facets of mindfulness were related to alcohol consumption and adverse consequences from drinking. After controlling for other variables, only the impulsivity domains of Negative Urgency (NU), Positive Urgency, and delay discounting were significantly related to alcohol consumption and only Lack of Premeditation and NU were significantly associated with drinking-related consequences. CONCLUSIONS: There was considerable overlap between some elements of impulsivity and mindfulness while the overlap was negligible for other facets. The associations between mindfulness and alcohol misuse were entirely a function of impulsivity. In particular, acting on impulses while experiencing a negative affect was significantly associated with level of alcohol consumption and level of alcohol-related risk. Steep discounting of future rewards was associated with alcohol consumption while poor premeditation was associated with adverse drinking consequences. These findings illustrate the importance of jointly studying impulsivity when examining mindfulness traits.

Neurofeedback in ADHD: a single-blind randomized controlled trial.

Neurofeedback treatment has been demonstrated to reduce inattention, impulsivity and hyperactivity in children with attention deficit/hyperactivity disorder (ADHD). However, previous studies did not adequately control confounding variables or did not employ a randomized reinforcer-controlled design. This study addresses those methodological shortcomings by comparing the effects of the following two matched biofeedback training variants on the primary symptoms of ADHD: EEG neurofeedback (NF) aiming at theta/beta ratio reduction and EMG biofeedback (BF) aiming at forehead muscle relaxation. Thirty-five children with ADHD (26 boys, 9 girls; 6-14 years old) were randomly assigned to either the therapy group (NF; n = 18) or the control group (BF; n = 17). Treatment for both groups consisted of 30 sessions. Pre- and post-treatment assessment consisted of psychophysiological measures, behavioural rating scales completed by parents and teachers, as well as psychometric measures. Training effectively reduced theta/beta ratios and EMG levels in the NF and BF groups, respectively. Parents reported significant reductions in primary ADHD symptoms, and inattention improvements in the NF group were higher compared to the control intervention (BF, d (corr) = -.94). NF training also improved attention and reaction times on the psychometric measures. The results indicate that NF effectively reduced inattention symptoms on parent rating scales and reaction time in neuropsychological tests. However, regarding hyperactivity and impulsivity symptoms, the results imply that non-specific factors, such as behavioural contingencies, self-efficacy, structured learning environment and feed-forward processes, may also contribute to the positive behavioural effects induced by neurofeedback training.

Dorsolateral prefrontal γ-aminobutyric acid in men predicts individual differences in rash impulsivity.

BACKGROUND: Impulsivity is a multifaceted personality construct associated with numerous psychiatric disorders. Recent research has characterized four facets of impulsivity: "urgency" (the tendency to act rashly especially in the context of distress or cravings); "lack of premeditation" (not envisaging the consequences of actions); "lack of perseverance" (not staying focused on a task); and "sensation seeking" (engaging in exciting activities). Urgency is particularly associated with clinical populations and problematic disinhibited behavior. METHODS: We used magnetic resonance spectroscopy to measure concentration of the inhibitory neurotransmitter γ-aminobutyric acid (GABA) in the dorsolateral prefrontal cortex (DLPFC) in two cohorts of 12 and 13 participants. RESULTS: We find that variation in trait urgency in healthy men correlates with GABA concentration in the DLPFC. The result was replicated in an independent cohort. More GABA predicted lower urgency scores, consistent with a role in self-control for GABA-mediated inhibitory mechanisms in DLPFC. CONCLUSIONS: These findings help account for individual differences in self-control and thus clarify the relationship between GABA and a wide range of psychiatric disorders associated with impaired self-control.

A cross-sectional investigation of trait disinhibition and its association with mindfulness and impulsivity.

Two online surveys were conducted to assess the relationship between trait disinhibition, impulsivity, mindfulness and adverse psychological symptoms. In study 1 adult females (n=196; mean age=21 yrs) completed the Three-Factor Eating Questionnaire (TEFQ-R21), the Hospital Anxiety and Depression Scale and a measure of dispositional mindfulness. In study 2 adult females (n=190; mean age=26 yrs) completed the same measures as in study 1 with the addition of the Barratt Impulsivity Scale. In both studies it was predicted that mindfulness would be negatively related to trait disinhibition controlling for adverse psychological symptoms. The second study addressed the additional hypothesis that the relationship between mindfulness and trait disinhibition would be mediated by impulsivity. Regression analyses indicated that mindfulness was negatively related to and explained 11% of variation in trait disinhibition (study 1). This relationship was replicated and extended in study 2 whereby impulsivity mediated the relationship between mindfulness and trait disinhibition. The findings warrant experimental and in vivo investigations of the potential causal relationships between mindfulness, impulsivity and eating behaviours.

Correlation of glutamate levels in the anterior cingulate cortex with self-reported impulsivity in patients with borderline personality disorder and healthy controls.

CONTEXT: Dysfunction and deficits in the structure of the anterior cingulate cortex have been reported in borderline personality disorder (BPD). To our knowledge, there is only 1 published study to date investigating anterior cingulate cortex metabolism in subjects with BPD and co-occurring attention-deficit/hyperactivity disorder using proton magnetic resonance spectroscopy. Impulsivity is a key feature of BPD and can be related to anterior cingulate cortex function. OBJECTIVE: To investigate whether anterior cingulate cortex metabolism may be altered in BPD and correlates with BPD pathology. DESIGN: Cross-sectional proton magnetic resonance spectroscopy study. SETTING: Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany. PARTICIPANTS AND PATIENTS: Thirty unmedicated female subjects meeting DSM-IV criteria for BPD and 31 age-matched healthy female control participants. MAIN OUTCOME MEASURES: Neurometabolite concentrations in the anterior cingulate cortex and correlation of glutamate levels with self-reported measures of impulsivity and severity of borderline symptoms. RESULTS: Significantly higher levels of glutamate in the anterior cingulate cortex were found in subjects with BPD as compared with healthy controls. A positive correlation between glutamate concentration and the Barratt Impulsiveness Scale total score as well as between glutamate concentration and the subscore for cognitive impulsivity were observed irrespective of diagnosis. We also found a positive correlation between glutamate concentrations and dissociation as well as between glutamate concentration and subscores of the Borderline Symptom List in the patient group. CONCLUSIONS: Our results support the hypothesis that higher glutamate concentration in the anterior cingulate cortex is associated with both severity of BPD symptoms and subjective impulsivity ratings, the latter independent of BPD. Further studies should confirm the association between enhanced glutamate concentration in the anterior cingulate cortex and behavioral measures of impulsivity.

Neurocognitive performance in children with ADHD and OCD.

Attention-deficit/hyperactivity Disorder (ADHD) and obsessive-compulsive disorder (OCD) have both been linked to dysfunction in the cortico-striato-thalamo-cortical circuitry (CSTCC). However, the exact nature of neurocognitive deficits remains to be investigated in both disorders. We applied two neuropsychological tasks that tap into different functions associated with the CSTCC, namely a serial reaction time (SRT) task, developed to assess implicit sequence learning, and a delay aversion (DA) task in order to assess abnormal motivational processes. The performance data of boys with ADHD (n=20), OCD (n=20) and healthy controls (n=25), all aged 10-18 years, were compared. Subjects with ADHD less frequently chose the larger, more delayed reward compared to those with OCD and controls, while subjects with OCD showed impaired implicit learning. In contrast, the ADHD group was unimpaired in their implicit learning behavior and the OCD group was not characterized by a DA style. Within the OCD-group, severity of obsessions was associated with implicit learning deficits and impulsive symptoms with DA in the ADHD-group. This double dissociation highlights the distinct cognitive dysfunctions associated with ADHD and OCD and might possibly point to different neural abnormalities in both disorders.

Increased error-related thalamic activity during early compared to late cocaine abstinence.

Altered cognitive control is implicated in the shaping of cocaine dependence. One of the key component processes of cognitive control is error monitoring. Our previous imaging work highlighted greater activity in distinct cortical and subcortical regions including the dorsal anterior cingulate cortex (dACC), thalamus and insula when participants committed an error during the stop signal task (Li et al., 2008b). Importantly, dACC, thalamic and insular activity has been associated with drug craving. One hypothesis is that the intense interoceptive activity during craving prevents these cerebral structures from adequately registering error and/or monitoring performance. Alternatively, the dACC, thalamus and insula show abnormally heightened responses to performance errors, suggesting that excessive responses to salient stimuli such as drug cues could precipitate craving. The two hypotheses would each predict decreased and increased activity during stop error (SE) as compared to stop success (SS) trials in the SST. Here we showed that cocaine dependent patients (PCD) experienced greater subjective feeling of loss of control and cocaine craving during early (average of day 6) compared to late (average of day 18) abstinence. Furthermore, compared to PCD during late abstinence, PCD scanned during early abstinence showed increased thalamic as well as insular but not dACC responses to errors (SE>SS). These findings support the hypothesis that heightened thalamic reactivity to salient stimuli co-occur with cocaine craving and loss of self control.