Impulsive responses to emotion as a transdiagnostic vulnerability to internalizing and externalizing symptoms

Authoritarianism and the brain: Structural MR correlates associated with polarized left- and right-wing ideology traits

Authoritarian attitudes across the political spectrum foster radical behaviors, which adversely affect the social fabric. Both left-wing (LWA) and right-wing (RWA) forms of authoritarianism have been described in relation to their psychological correlates, yet little is known about their neurobiological basis. In this study, we explored brain structural correlates (e.g., in cortical thickness (CT) and gray matter (GM) volume) of authoritarianism. For this purpose, we assessed authoritarian dispositions in a sample of 100 young adults and collected 3 T MR images. Images were computed using the CAT12 toolbox. Behaviorally, both the LWA and RWA were positively associated with negative urgency; the LWA also showed a robust positive association with trait anxiety. At the neural level, results showed a negative correlation (r = -0.48) between RWA and a GM volume cluster located in the dorsomedial prefrontal cortex (dmPFC). In addition, we also observed a negative correlation (r = -0.41) between the LWA anti-hierarchical aggression subscale and a CT cluster located in the right anterior insula. Additionally, the resulting clusters converged with further left-wing and right-wing ideology scales related to LWA and RWA, thus providing a robustness check. These results are supported by previous studies showing the relevance of the dmPFC and the anterior insula on social cognition and empathy/inhibitory control, respectively.

Antisocial Personality Disorder in Mexican Women: A Study of Sociodemographic Variables and Comorbid Mental Disorders

INTRODUCTION

Antisocial personality disorder (APD) is mainly based on social irresponsibility that leads to delinquent, criminal, and exploitative behavior toward others, as well as difficulty in adapting to social norms. This disorder predominates in the male gender, and therefore, most of the research to date has been conducted in men. In the following study, we aimed to describe the main sociodemographic variables and psychiatric comorbidities presented in women with a diagnosis of APD.

METHODS

We assessed 54 women with a diagnosis of APD, of whom sociodemographic characteristics were collected, and the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders-IV Axis II Disorders (SCID-II) and the Mini-International Neuropsychiatric Interview (M.I.N.I.) 5.0.0 were applied.

RESULTS

We found a weak positive correlation with the obsessive (rs = 0.28, p = 0.039), passive-aggressive (rs = 0.29, p = 0.034), paranoid (rs = 0.39, p = 0.004), narcissistic (rs = 0.36, p = 0.008), and borderline (rs = 0.35, p = 0.010) personality domains, with a median age of 24.00 (IQR = 11.50) years, and the majority mainly being single and unemployed. We also found high rates of suicidal risk, depression, anxiety, and substance abuse, which was consistent with what has been reported elsewhere.

CONCLUSION

Research on APD and its comorbidities in women is limited, especially in Mexico, where women with APD show similar patterns to those in developed countries. This suggests the need for gender-specific interventions and a dimensional approach to improve the diagnosis and treatment of APD.

Cognitive Training for Emotion-Related Impulsivity and Rumination: Protocol for a Pilot Randomized Waitlist-Controlled Trial

BACKGROUND

Inhibitory deficits are common in psychopathology. Emotion-related impulsivity (ERI) and rumination are general risk factors for psychiatric distress that are similarly associated with dysfunctional inhibition-particularly in affective contexts. A number of cognitive remediation procedures have been developed to improve inhibitory control; however, most remediation programs focus on "cold" cognition independent of affective processing. This pilot trial will gather preliminary evidence for a new cognitive training intervention targeting "hot" affective control (ie, inhibitory functions during elevated emotional arousal) in a transdiagnostic sample of adults who report heightened emotion dysregulation.

OBJECTIVE

This manuscript describes a protocol for a pilot randomized waitlist-controlled trial to assess changes in ERI and rumination after neurobehavioral affective control training (N-ACT), an 8-week cognitive training intervention designed to improve emotional response inhibition and emotional working memory. Our primary aim is to evaluate the efficacy, feasibility, and acceptability of N-ACT in reducing rumination and ERI, which we respectively conceptualize as complementary cognitive and behavioral consequences of emotion dysregulation. Secondarily, we will examine whether N-ACT leads to improvements in inhibitory control and, more distally, psychopathology symptoms.

METHODS

The final sample will comprise 80 adults who report high ERI or rumination. Participants will be randomized to (1) begin the N-ACT program without delay or (2) join a waitlist condition and then complete N-ACT. Exclusion criteria include active alcohol or substance use disorders, psychosis, and suicide risk. At the baseline and postintervention time points, participants will complete measures of emotion dysregulation and psychiatric symptoms, as well as a neuropsychological assessment of inhibitory control. Individuals assigned to the control group will undergo an identical assessment before joining the waitlist, followed by parallel assessments before and after N-ACT.

RESULTS

This trial is funded by support from the University of California Board of Regents and the Peder Sather Foundation (funding period: October 2022-September 2025). Recruitment is scheduled to begin in spring 2025. We will begin data analysis once data collection is complete, which is planned to occur in fall 2025.

CONCLUSIONS

This pilot randomized waitlist-controlled trial is designed to assess the initial efficacy, feasibility, and acceptability of N-ACT, a novel cognitive remediation approach developed to address 2 key contributors to psychopathology: ERI and rumination. The N-ACT program uses computerized adaptive behavioral tasks to strengthen the affective control processes theoretically and empirically linked to ERI and rumination. We hope this work will help inform future studies with sufficient statistical power to ascertain whether enhancing affective control through cognitive training (N-ACT) produces downstream reductions in psychiatric symptoms via improved emotion regulation.

TRIAL REGISTRATION

ClinicalTrials.gov NCT06226467; https://www.clinicaltrials.gov/study/NCT06226467; Open Science Framework Registry rak5z; https://osf.io/rak5z.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/54221.

Alcohol outcomes on anxiety, impulsivity and spatial memory: Possible Omega-3 amelioration effects

Alcohol consumption is a worldwide concern that causes 5 % of the global disease burden and contributes to 3 million deaths per year. Several studies suggest an increase in alcohol drinking and alcohol related problems. Alcohol Use Disorder (formerly referred as alcoholism or alcohol addiction) is one of many possible outcomes of an early and prolonged alcohol consumption and it is highly comorbid with anxiety disorders, impulsivity and memory deficits among others. In this review we approach recent data about global and American prevalence of alcohol use and discuss different factors that contribute to alcohol consumption. Furthermore, we revise evidence of ethanol effects on anxiety-like behaviors, impulsivity and spatial memory. Lastly, we look at the Omega-3 fatty acid as a possible course of action in mitigating the aforementioned deleterious effects of alcohol consumption.

The Memory and Affective Flexibility Task: a new behavioral tool to assess neurocognitive processes implicated in emotion-related impulsivity and internalizing symptoms

Background

Cognitive rigidity and working memory impairment are established features of internalizing syndromes. Growing evidence suggests that deficits in affective control -cognitive control in the context of emotion - may underpin elevated emotion-related impulsivity in various psychiatric disorders.

Objective

This study examines two components of affective control (affective flexibility and emotional working memory) as potential neurocognitive processes linking emotion-related impulsivity to internalizing psychopathology.

Method

Undergraduate participants (analysis n = 120) completed the Memory and Affective Flexibility Task (MAFT), a novel behavioral assessment designed to assess hot cognition in affective flexibility and emotional working memory performance, alongside self-report measures of impulsivity and symptoms of internalizing disorders.

Results

Structural equation modeling suggested that less accurate working memory during neutral trials (cool cognition) was associated with more symptoms of internalizing psychopathology. However, effects of hot working memory and affective flexibility were not significantly related to emotion-related impulsivity or psychopathology scores.

Conclusions

Although findings provide no support for the validity of MAFT indices of hot cognition, these results replicate and extend work on the importance of cool working memory and emotion-related impulsivity as correlates of psychopathology.

Emotion-related impulsivity is related to orbitofrontal cortical sulcation

BACKGROUND

Emotion-related impulsivity (ERI) describes the trait-like tendency toward poor self-control when experiencing strong emotions. ERI has been shown to be elevated across psychiatric disorders and predictive of the onset and worsening of psychiatric syndromes. Recent work has correlated ERI scores with the region-level neuroanatomical properties of the orbitofrontal cortex (OFC), but not posteromedial cortex (PMC). Informed by a growing body of research indicating that examining the morphology of specific cortical folds (sulci) can produce unique insights into behavioral outcomes, the present study modeled the association between ERI and the morphology of sulci within OFC and PMC, which is a finer scale than previously conducted.

METHODS

Analyses were conducted in a transdiagnostic sample of 118 adult individuals with a broad range of psychiatric syndromes. First, we manually defined over 4,000 sulci across 236 cerebral hemispheres. Second, we implemented a model-based LASSO regression to relate OFC sulcal morphology to ERI. Third, we tested whether effects were specific to OFC sulci, sulcal depth, and ERI (as compared to PMC sulci, sulcal gray matter thickness, and non-emotion-related impulsivity).

RESULTS

The LASSO regression revealed bilateral associations of ERI with the depths of eight OFC sulci. These effects were strongest for OFC sulci, sulcal depth, and ERI in comparison to PMC sulci, sulcal gray matter thickness, and non-emotion-related impulsivity. In addition, we identified a new transverse component of the olfactory sulcus in every hemisphere that is dissociable from the longitudinal component based on anatomical features and correlation with behavior, which could serve as a new transdiagnostic biomarker.

CONCLUSIONS

The results of this data-driven investigation provide greater neuroanatomical and neurodevelopmental specificity on how OFC is related to ERI. As such, findings link neuroanatomical characteristics to a trait that is highly predictive of psychopathology.

Variable Presence of an Evolutionarily New Brain Structure Is Related to Trait Impulsivity

BACKGROUND

Impulsivity is a multidimensional construct reflecting poor constraint over one's behaviors. Clinical psychology research has identified separable impulsivity dimensions that are each unique transdiagnostic indicators for psychopathology. However, despite this apparent clinical importance, the shared and unique neuroanatomical correlates of these factors remain largely unknown. Concomitantly, neuroimaging research has identified variably present human brain structures implicated in cognition and disorder: the folds (sulci) of the cerebral cortex located in the latest-developing and most evolutionarily expanded hominoid-specific association cortices.

METHODS

We tethered these 2 fields to test whether variability in one such structure in the anterior cingulate cortex (ACC)-the paracingulate sulcus (PCGS)-was related to individual differences in trait impulsivity. A total of 120 adult participants with internalizing or externalizing psychopathology completed a magnetic resonance imaging scan and the Three-Factor Impulsivity Index. Using precision imaging techniques, we manually identified the PCGS, when present, and acquired quantitative folding metrics (PCGS length and ACC local gyrification index).

RESULTS

Neuroanatomical-behavioral analyses revealed that participants with leftward or symmetrical PCGS patterns had greater severity of Lack of Follow Through (LFT)-which captures inattention and lack of perseverance-than those with rightward asymmetry. Neuroanatomical-functional analyses identified that the PCGS colocalized with a focal locus found in a neuroimaging meta-analysis on a feature underlying LFT. Neither quantitative folding metric related to any impulsivity dimension.

CONCLUSIONS

This study advances understanding of the neuroanatomical correlates of impulsivity and establishes the notion that the topographical organization of distinct, hominoid-specific cortical expanses underlies separable impulsivity dimensions with robust, transdiagnostic implications for psychopathology.

Variable Presence of an Evolutionarily New Brain Structure is Related to Trait Impulsivity

Background

Impulsivity is a multidimensional construct reflecting poor constraint over one's behaviors. Clinical psychology research identifies separable impulsivity dimensions that are each unique transdiagnostic indicators for psychopathology. Yet, despite this apparent clinical importance, the shared and unique neuroanatomical correlates of these factors remain largely unknown. Concomitantly, neuroimaging research identifies variably present human brain structures implicated in cognition and disorder: the folds (sulci) of the cerebral cortex located in the latest developing and most evolutionarily expanded hominoid-specific association cortices.

Methods

We tethered these two fields to test whether variability in one such structure in anterior cingulate cortex (ACC)-the paracingulate sulcus (PCGS)-was related to individual differences in trait impulsivity. 120 adult participants with internalizing or externalizing psychopathology completed a magnetic resonance imaging scan and the Three-Factor Impulsivity Index. Using precision imaging techniques, we manually identified the PCGS, when present, and acquired quantitative folding metrics (PCGS length and ACC local gyrification index).

Results

Neuroanatomical-behavioral analyses revealed that participants with leftward or symmetrical PCGS patterns had greater severity of Lack of Follow Through (LFT)-which captures inattention and lack of perseverance-than those with rightward asymmetry. Neuroanatomical-functional analyses identified that the PCGS co-localized with a focal locus found in a neuroimaging meta-analysis on a feature underlying LFT. Both quantitative folding metrics did not relate to any impulsivity dimension.

Conclusions

This study advances understanding of the neuroanatomical correlates of impulsivity and establishes the notion that the topographical organization of distinct, hominoid-specific cortical expanses underlie separable impulsivity dimensions with robust, transdiagnostic implications for psychopathology.

Contexts of urgency may go beyond emotion

Introduction

Urgency has been defined as the tendency towards rash speech and behavior in the context of emotion. Measures of Urgency have been found to have robust predictive power for psychopathologies and problematic behaviors. In the current study, we question whether emotions are unique drivers of urgency, or if emotions are potent exemplars of contexts that lead to rash speech and behavior. The Emotion Specific model and the Broader Contexts model correspond with these two conceptualizations of urgency, and they frame our pre-registered hypotheses.

Methods

Participants from two well-powered samples (n = 600,n = 588) completed 9 modified items from the Urgency and Positive Urgency scales to assess rash responses in each of four contexts - "Upset," "Excited," "Tired," and "Hungry" - and a fifth "In General" set. After data cleaning, we used principal components analysis to construct a unidimensional, 4-item set that was applied to capture impulsive behavior across the five contexts.

Results

We found that this research tool, called the Contexts of Impulsive Behaviors (CIBS), replicated in the second dataset, and it had adequate internal reliability in both samples. Although the Emotion Specific model was supported by the fact that the Upset context had a greater mean and greater variance than the Tired and Hungry contexts, most results supported the Broader Contexts model. That is, CIBS contexts were highly intercorrelated, and bivariate correlations with psychopathology were not significantly different across contexts. In partial correlations, effects of the Upset and Excited contexts were partially or fully statistically mediated by the Tired and Hungry contexts.

Discussion

These findings suggest that emotions are potent contexts for impulsive behaviors. At the same time, those with high urgency are vulnerable to impulsivity in other contexts, such as fatigue and hunger, that challenge the regulatory functions of the prefrontal cortex. Limitations, future directions, and clinical implications are discussed.

Executive Function and Impulsivity Predict Distinct Genetic Variance in Internalizing Problems, Externalizing Problems, Thought Disorders, and Compulsive Disorders: A Genomic Structural Equation Modeling Study

Individual differences in self-control predict many health and life outcomes. Building on twin literature, we used genomic structural equation modeling to test the hypothesis that genetic influences on executive function and impulsivity predict independent variance in mental health and other outcomes. The impulsivity factor (comprising urgency, lack of premeditation, and other facets) was only modestly genetically correlated with low executive function (rg =.13). Controlling for impulsivity, low executive function was genetically associated with increased internalizing (βg =.15), externalizing (βg =.13), thought disorders (βg =.38), compulsive disorders (βg =.22), and chronotype (βg =.11). Controlling for executive function, impulsivity was positively genetically associated with internalizing (βg =.36), externalizing (βg =.55), body mass index (βg =.26), and insomnia (βg =.35), and negatively genetically associated with compulsive disorders (βg = -.17). Executive function and impulsivity were both genetically correlated with general cognitive ability and educational attainment. This work suggests that executive function and impulsivity are genetically separable and show independent associations with mental health.

Impulsivity and Its Association with Depression and Anxiety in the Normal Egyptian Population Post COVID-19 Pandemic

Background and Objectives: It is well known that depression, anxiety, and impulsiveness are interrelated; however, studies that have assessed their association with the coronavirus outbreak are scarce. Hence, our study aimed to evaluate the impulsivity incidence and its correlation with anxiety and depression following COVID-19 infection between November 2022 and June 2023. Materials and Methods: The 201 participants completed the Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HAM-A), Sheehan Disability Scale (SDS), and short UPPS-P scales (urgency, premeditation, perseverance, sensation seeking, and positive urgency) to allow us to determine their anxiety and depression symptoms, functional impairment, and impulsivity, respectively. Results: Among our respondents, 22%, and 26.7% had moderate to severe anxiety and depression. The short UPPS-P scale significantly correlated with the HAM-A and HDRS scales. Participants with positive COVID-19 infection showed significantly higher functional impairment scores, especially in the work/study domain (mean (SD): 3.12 (2.2) vs. 2.43 (2.3); p = 0.037). COVID-19-related disruption significantly correlated with negative and positive urgency, HAM-A, HDRS, and the SDS total and subscales. Conclusions: Our findings showed a notable increase in anxiety, depression, and functional impairment among the population following COVID-19 infection. Our research highlights the correlation between impulsivity and the psychological distress experienced following the pandemic.

Negative urgency as a state-level process

OBJECTIVE

Test whether global self-reports of urgency moderated the within-person associations of affect and impulsive behaviors.

BACKGROUND

Negative urgency is a personality trait that is a risk factor for a range of psychopathology. Although it is assumed that global self-reports of urgency measure individual tendencies to act more impulsively in the face of negative emotions, evidence from ecological momentary assessment studies is mixed.

METHOD

In this Registered Report, we used ecological momentary assessment data from a large sample of young adults (n = 496, age 18-22, 5 surveys per day for 40 days).

RESULTS

All forms of momentary impulsivity were impaired in moments when people reported more intense negative emotions, but global self-reports of urgency did not explain individual differences in this association. Moreover, averaged affective states, rather than specific dimensions, affective circumplex, or appraisals, best predicted impulsive states.

CONCLUSIONS

Results suggest that face-valid interpretations of global self-report of urgency are inaccurate, and it may be important to understand how some people come to understand themselves as high on urgency rather than assuming that people's self-reports of their motivations are accurate. Momentary experiences of emotions globally impact multiple weakly to moderately associated impulsive behaviors, and future research should seek to understand both when and for whom these associations are strongest.

Dual-systems models of the genetic architecture of impulsive personality traits: neurogenetic evidence of distinct but related factors

BACKGROUND

Dual-systems models, positing an interaction between two distinct and competing systems (i.e. top-down self-control, and bottom-up reward- or emotion-based drive), provide a parsimonious framework for investigating the interplay between cortical and subcortical brain regions relevant to impulsive personality traits (IPTs) and their associations with psychopathology. Despite recent developments in multivariate analysis of genome-wide association studies (GWAS), molecular genetic investigations of these models have not been conducted.

METHODS

Using IPT GWAS, we conducted confirmatory genomic structural equation models (GenomicSEM) to empirically evaluate dual-systems models of the genetic architecture of IPTs. Genetic correlations between dual-systems factors and relevant cortical and subcortical neuroimaging phenotypes (regional/structural volume, cortical surface area, cortical thickness) were estimated and compared.

RESULTS

GenomicSEM dual-systems models underscored important sources of shared and unique genetic variance between top-down and bottom-up constructs. Specifically, a dual-systems genomic model consisting of sensation seeking and lack of self-control factors demonstrated distinct but related sources of genetic influences (rg = 0.60). Genetic correlation analyses provided evidence of differential associations between dual-systems factors and cortical neuroimaging phenotypes (e.g. lack of self-control negatively associated with cortical thickness, sensation seeking positively associated with cortical surface area). No significant associations were observed with subcortical phenotypes.

CONCLUSIONS

Dual-systems models of the genetic architecture of IPTs tested were consistent with study hypotheses, but associations with relevant neuroimaging phenotypes were mixed (e.g. no associations with subcortical volumes). Findings demonstrate the utility of dual-systems models for studying IPT genetic influences, but also highlight potential limitations as a framework for interpreting IPTs as endophenotypes for psychopathology.

Urged to feel certain again: The role of emotion-related impulsivity on the relationships between intolerance of uncertainty and OCD symptom severity

OBJECTIVES

Obsessive-compulsive disorder (OCD) is a debilitating mental disorder characterized by persistent and intrusive thoughts accompanied by repetitive mental or physical acts. While both intolerance of uncertainty and emotion-related impulsivity have been consistently evidenced as cognitive risk factors of OCD, no studies have considered their joint effects. The current study examined the interaction between intolerance of uncertainty and two forms of emotion-related impulsivity-including both a behavioural and cognitive form-in predicting OCD symptoms.

DESIGN

Cross-sectional data were collected online from community-based adult participants.

METHODS

Participants (N = 673) completed a battery of self-report measures of OCD symptom severity, intolerance of uncertainty, and emotion-related impulsivity.

RESULTS

The behavioural form of emotion-related impulsivity positively moderated the relationship between intolerance of uncertainty and OCD symptoms. Elevated levels of both factors predicted the most severe symptoms, particularly checking, washing, and obsessing. This interaction effect was not found for the cognitive form of emotion-related impulsivity, which still emerged as a unique predictor of OCD symptom severity, specifically obsessing symptoms.

CONCLUSIONS

Current findings furthered the understanding of the link between intolerance of uncertainty and OCD symptoms by highlighting the role of emotion-related impulsivity. When uncertainty triggers distress in individuals with high intolerance of uncertainty, the urge to behaviourally alleviate this distress could promote the use of maladaptive obsessions and compulsions, leading to greater OCD symptoms. Results also indicated the potentially differential effects from the behavioural versus cognitive forms of emotion-related impulsivity on different symptom domains, and the mechanistic link here is worthy of further investigation.

Neural and psychological correlates of post-traumatic stress symptoms in a community adult sample

A multitude of factors are associated with the symptoms of post-traumatic stress disorder. However, establishing which predictors are most strongly associated with post-traumatic stress disorder symptoms is complicated because few studies are able to consider multiple factors simultaneously across the biopsychosocial domains that are implicated by existing theoretical models. Further, post-traumatic stress disorder is heterogeneous, and studies using case-control designs may obscure which factors relate uniquely to symptom dimensions. Here we used Bayesian variable selection to identify the most important predictors for overall post-traumatic stress disorder symptoms and individual symptom dimensions in a community sample of 569 adults (18 to 85 yr of age). Candidate predictors were selected from previously established risk factors relevant for post-traumatic stress disorder and included psychological measures, behavioral measures, and resting state functional connectivity among brain regions. In a follow-up analysis, we compared results controlling for current depression symptoms in order to examine specificity. Poor sleep quality and dimensions of temperament and impulsivity were consistently associated with greater post-traumatic stress disorder symptom severity. In addition to self-report measures, brain functional connectivity among regions commonly ascribed to the default mode network, central executive network, and salience network explained the unique variability of post-traumatic stress disorder symptoms. This study demonstrates the unique contributions of psychological measures and neural substrates to post-traumatic stress disorder symptoms.

Emotion-related impulsivity across transdiagnostic dimensions of psychopathology

OBJECTIVE

Several dimensions have received attention for their potential role in explaining shared variance in transdiagnostic symptoms of psychopathology. We hypothesized emotion-related impulsivity, the trait-like tendency toward difficulty restraining responses to emotion, would relate to symptoms of psychopathology, with two separable dimensions of emotion-related impulsivity relating distinctly to internalizing and externalizing symptoms.

METHOD

Across two studies, we tested hypotheses using structural equation models of emotion-related impulsivity and multiple indicators of internalizing, externalizing, and thought symptoms.

RESULTS

In Study 1 (658 undergraduates), emotion-related impulsivity was highly correlated with the general psychopathology (p) factor. In study 2 (421 Mechanical Turk participants), models did not support a general p factor; however, we replicated the hypothesized associations of emotion-related impulsivity dimensions with internalizing and externalizing factors. Across both studies, forms of emotion-related impulsivity uniquely and differentially related to internalizing and externalizing symptoms.

CONCLUSIONS

Findings indicate emotion-related impulsivity may help explain transdiagnostic dimensions of psychopathology, such as the p factor.

Emotion Regulation, Parenting, and Psychopathology: A Systematic Review

The presence of a parental mental disorder can lead to adverse outcomes for children. Difficulties in emotion regulation are observed across a range of mental health problems and may play a crucial role in this context. Following PRISMA guidelines, we systematically searched Medline, PsycINFO, Embase, and Web of Science for studies examining the association between emotion regulation in parents with psychopathology at a clinical or subclinical level and their parenting. The protocol was registered with the PROSPERO international prospective register of systematic reviews (CRD42021224954; January 2021). A total of 23 studies were included in the qualitative synthesis. Emotion regulation was predominantly assessed using self-report on the general ability (e.g., Difficulties in Emotion Regulation Scale). The assessment of parenting encompassed a broad range of aspects and operationalizations. Across psychopathology in parents, several aspects of difficulties in emotion regulation were associated with unfavorable emotion socialization, more negative parenting, and partially with less positive parenting. Slightly different effects were observed for posttraumatic stress disorder and anxiety disorders. For parents with depressive disorders, specific emotion regulation strategies (suppression, reappraisal) seem to buffer against negative parenting. Since the majority of studies refer only to mothers, generalization to fathers is limited. Furthermore, conclusions are limited due to study heterogeneity and lack of prospective studies. Nevertheless, findings suggest that interventions should target the improvement of emotion regulation in parents with psychopathology.

On the impulsivity path: Examining the unique and conjoint relations between emotion- and non-emotion-related impulsivity, internalizing symptoms, alcohol use, and physical health parameters

BACKGROUND

Researchers have increasingly differentiated trait-like tendencies toward impulsivity occurring during emotional states (emotion-related impulsivity [ERI]) from impulsivity not tied to emotion (non-ERI). Relative to non-ERI, ERI has shown robust correlations with psychopathology and mild to moderate associations with physical health parameters (e.g., physical activity, poor sleep quality, body mass index [BMI]). Therefore, we first aimed to investigate the unique contributions of ERI and non-ERI to psychopathology symptoms while controlling for neuroticism. Second, we sought to explore the combined associations of physical health parameters with several impulsivity forms.

METHODS

German-speaking adults (N = 350, 35.9 ± 14.6 years, 69.1% female, BMI: 24.0 ± 4.8 kg/m2 , mostly students or employees) completed measures of impulsivity, psychopathology symptoms, neuroticism, and physical health. We gathered measures of two ERI forms: Feelings Trigger Action and Pervasive Influence of Feelings. As a control comparison, we gathered a measure of non-ERI, the Lack of Follow-Through scale. We conducted separate path models for Aims 1 and 2.

RESULTS

For Aim 1, Pervasive Influence of Feelings showed strong links with internalizing symptoms. Feelings Trigger Action and Lack of Follow-Through showed small links with alcohol use. For Aim 2, poor sleep quality was related to all three impulsivity factors, while physical activity was only related to Pervasive Influence of Feelings and Lack of Follow-Through. BMI showed a curvilinear association with impulsivity.

CONCLUSIONS

ERI is more directly relevant than non-ERI for psychopathology symptoms, emphasizing the need to differentiate between the two ERI types. The association of ERI and non-ERI with physical activity and poor sleep quality may serve as potential treatment targets for impulsivity-related problems.

Negative urgency, distress tolerance, and symptoms of substance use, eating, and borderline personality disorders in treatment-seeking young people

OBJECTIVE

Negative urgency (NU) and distress tolerance (DT) are two similar yet distinct constructs with putative transdiagnostic relevance, particularly across psychopathology characterized by impulsivity (e.g., substance use disorders [SUD], eating disorders featuring binging and/or purging ED-B/P, and borderline personality disorder [BPD]). Yet, there remains a lack of research into NU and DT across SUD, ED-B/P, and BPD symptomatology in clinical populations. The present study sought to elucidate the transdiagnostic utility of NU and DT across impulsive-type psychology by examining the unique and interactive roles of NU and DT across SUD, ED-B/P, and BPD symptomatology within a treatment-seeking sample of young people.

METHOD

Participants (N = 385; 62.3% female; aged 16-25 years) were recruited from youth health services across Melbourne, Australia. Participants completed an online survey including self-report measures of NU and DT as well as SUD, ED-B/P, and BPD symptoms. Mixed effects logistic regression was used to explore unique and interactive associations of NU and DT with symptoms.

RESULTS

Both NU (adjusted odds ratio [ORadj ] = 1.22; 95% confidence interval [CI] = [1.16, 1.28]) and global DT (ORadj  = 0.59; 95% CI = [0.47, 0.74]) uniquely predicted symptoms. However, associations with global DT and most of its components differed across psychopathology types. No significant interactions between NU and DT in predicting symptoms were found.

CONCLUSIONS

These results support the transdiagnostic utility of NU across SUD, ED-B/P, and BPD, while suggesting the role of DT across these disorders is more nuanced. These findings have important implications for NU and DT as potential intervention targets.

Emotion-related impulsivity is related to orbitofrontal cortical sulcation

Background

Emotion-related impulsivity (ERI) describes the trait-like tendency toward poor self-control when experiencing strong emotions. ERI has been shown to be elevated across psychiatric disorders and predictive of the onset and worsening of psychiatric syndromes. Recent work has correlated ERI scores with the neuroanatomy of the orbitofrontal cortex (OFC). Informed by a growing body of research indicating that the morphology of cortical folds (sulci) can produce insights into behavioral outcomes, the present study modeled the association between ERI and the sulcal morphology of OFC at a finer scale than previously conducted.

Methods

Analyses were conducted in a transdiagnostic sample of 118 individuals with a broad range of psychiatric syndromes. We first manually defined over 2000 sulci across the 118 participants. We then implemented a model-based LASSO regression to relate OFC sulcal morphology to ERI and test whether effects were specific to ERI as compared to non-emotion-related impulsivity.

Results

The LASSO regression revealed bilateral associations of ERI with the depth of eight OFC sulci. These effects were specific to ERI and were not observed in non-emotion-related impulsivity. In addition, we identified a new transverse component of the olfactory sulcus in every hemisphere that is dissociable from the longitudinal component based on anatomical features and correlation with behavior, which could serve as a new transdiagnostic biomarker.

Conclusions

The results of this data-driven investigation provide greater neuroanatomical and neurodevelopmental specificity on how OFC is related to ERI. As such, findings link neuroanatomical characteristics to a trait that is highly predictive of psychopathology.

Does Emotion-Related Impulsivity Relate to Specific ADHD Symptom Dimensions, and Do the Effects Generalize Across Comorbid Internalizing and Externalizing Syndromes?

BACKGROUND

Recent work highlights the role of emotion dysregulation in the pathology of Attention-Deficit/Hyperactivity Disorder (ADHD). As such, emotion-related impulsivity (ERI), the trait-like tendency toward disinhibited thoughts (Pervasive Influence of Feelings, PIF) and actions (Feelings Trigger Action, FTA) during heightened emotional states, may be particularly relevant. We explored whether Inattention (IN) and Hyperactivity/Impulsivity (HI), two core symptom dimensions of ADHD, would relate to distinct facets of ERI, and whether externalizing and internalizing symptoms would moderate these relations.

METHOD

Using structural equation modeling, we examined hypotheses among 364 adults recruited for high internalizing and externalizing symptoms.

RESULTS

We identified significant paths for FTA regressed on HI and PIF regressed on IN, supporting our hypotheses about main effects. Moderating paths were not significant.

CONCLUSIONS

IN and HI correlate with distinct forms of ERI, These effects appear to generalize across co-occurring internalizing and externalizing symptoms. Theoretical and clinical implications are discussed.

Neuroanatomical Correlates of Emotion-Related Impulsivity

BACKGROUND

Emotion-related impulsivity (ERI) refers to chronically poor self-control during periods of strong emotion. ERI robustly predicts psychiatric disorders and related problems, yet its neuroanatomical correlates are largely unknown. We tested whether local brain morphometry in targeted brain regions that integrate emotion and control could explain ERI severity.

METHODS

One hundred twenty-two adults (ages 18-55 years) with internalizing or externalizing psychopathology completed a structural magnetic resonance imaging (MRI) scan, the Three-Factor Impulsivity Index, and the Structured Clinical Interview for DSM-5. The Three-Factor Impulsivity Index measures two types of ERI and a third type of impulsivity not linked to emotion. Cortical reconstruction yielded cortical thickness and local gyrification measurements. We evaluated whether morphometry in the orbitofrontal cortex (OFC), insula, amygdala, and nucleus accumbens was associated with ERI severity. Hypotheses and analyses were preregistered.

RESULTS

Lower cortical gyrification in the right lateral OFC was associated with high ERI severity in a full, preregistered model. Separate examinations of local gyrification and cortical thickness also showed a positive association between gyrification in the left lateral OFC and ERI. An integrated measure of hemispheric imbalance in lateral OFC gyrification (right < left) correlated with ERI severity. These findings were specific to ERI and did not appear with non-emotion-related impulsivity.

CONCLUSIONS

Local gyrification in the lateral OFC is associated with ERI severity. The current findings fit with existing theories of OFC function, strengthen the connections between the transdiagnostic literature in psychiatry and neuroscience, and may guide future treatment development.

Dual-systems models of the genetic architecture of impulsive personality traits: Neurogenetic evidence of distinct but related factors

Background

Dual-systems models provide a parsimonious framework for understanding the interplay between cortical and subcortical brain regions relevant to impulsive personality traits (IPTs) and their associations with psychiatric disorders. Despite recent developments in multivariate analysis of genome-wide association studies (GWAS), molecular genetic investigations of these models have not been conducted.

Methods

Using extant IPT GWAS, we conducted confirmatory genomic structural equation models (GenomicSEM) to empirically evaluate dual-systems models of the genetic architecture of IPTs. Genetic correlations between results of multivariate GWAS of dual-systems factors and GWAS of relevant cortical and subcortical neuroimaging phenotypes (regional/structural volume, cortical surface area, cortical thickness) were calculated and compared.

Results

Evaluation of GenomicSEM model fit indices for dual-systems models suggested that these models highlight important sources of shared and unique genetic variance between top-down and bottom-up constructs. Specifically, a dual-systems genomic model consisting of sensation seeking and lack of self-control factors demonstrated distinct but related sources of genetic influences ( r g =.60). Genetic correlation analyses provided evidence of differential associations between dual-systems factors and cortical neuroimaging phenotypes (e.g., lack of self-control negatively associated with cortical thickness, sensation seeking positively associated with cortical surface area). However, no significant associations were observed for subcortical phenotypes inconsistent with hypothesized functional localization of dual-systems constructs.

Conclusions

Dual-systems models of the genetic architecture of IPTs tested here demonstrate evidence of shared and unique genetic influences and associations with relevant neuroimaging phenotypes. These findings emphasize potential advantages in utilizing dual-systems models to study genetic influences for IPTs and transdiagnostic associations with psychiatric disorders.

Bottom-up transdiagnostic personality subtypes are associated with state psychopathology: A latent profile analysis

Introduction

Personality-based profiling helps elucidate associations between psychopathology symptoms and address shortcomings of current nosologies. The objective of this study was to bracket the assumption of a priori diagnostic class borders and apply the profiling approach to a transdiagnostic sample. Profiles resembling high-functioning, undercontrolled, and overcontrolled phenotypes were expected to emerge.

Methods

We used latent profile analysis on data from a sample of women with mental disorders (n = 313) and healthy controls (n = 114). 3-5 profile solutions were compared based on impulsivity, perfectionism, anxiety, stress susceptibility, mistrust, detachment, irritability, and embitterment. The best-fitting solution was then related to measures of depression, state anxiety, disordered eating, and emotion regulation difficulties to establish clinical significance.

Results

A 5-profile solution proved best-fitting. Extracted profiles included a high-functioning, a well-adapted, an impulsive and interpersonally dysregulated, an anxious and perfectionistic, and an emotionally and behaviorally dysregulated class. Significant differences were found in all outcome state measures, with the emotionally and behaviorally dysregulated class exhibiting the most severe psychopathology.

Discussion

These results serve as preliminary evidence of the predictive nature and clinical utility of personality-based profiles. Selected personality traits should be considered in case formulation and treatment planning. Further research is warranted to replicate the profiles and assess classification stability and profiles' association with treatment outcome longitudinally.

Empirical support for a dual process model of the p-factor: Interaction effects between preschool executive control and preschool negative emotionality on general psychopathology

Recent work indicates that a general factor, often referred to as the p-factor, underlies nearly all forms of psychopathology. Although the criterion validity and utility of this general factor have been well supported, questions remain about the substantive meaning of the p-factor. The purpose of the present longitudinal study was to empirically test the hypothesis that the p-factor reflects dysregulation arising from a combination of high dispositional negative emotionality and low executive control. The current study examined preschool executive control, measured using a battery of 9 developmentally appropriate executive control tasks, as a moderator of the association between preschool negative emotionality and both concurrent and subsequent levels of general psychopathology in preschool and elementary school using a community sample (N = 497). Latent moderated structural equation models demonstrated that preschool executive control significantly moderated the associations between preschool negative emotionality and general psychopathology both in preschool and approximately 5 years later in elementary school. These results suggest that the general factor of psychopathology may reflect dysregulation arising from a tendency to experience high negative affect, without sufficient executive control to effectively down-regulate that affect. This work has important implications for identifying transdiagnostic targets for prevention and intervention efforts, as well as furthering understanding of the substantive meaning and construct validity of the general factor of psychopathology. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The Effects of Virtual Reality in Targeting Transdiagnostic Factors for Mental Health: A Systematic Review of the Literature

Virtual reality (VR) was found to be effective in the treatment of several specific psychopathologies. However, the effects of VR-based interventions beyond the disorder-specific approach and their ability to improve transdiagnostic factors of mental disorders are unknown. This PRISMA systematic review was conducted using databases PubMed and PsycINFO, searching articles published between 2010 and September 2022. Keywords “emotion regulation”, “cognitive reappraisal”, “avoidance”, “impulsivity”, “aggression”, and “disinhibition” were combined with “virtual reality” to retrieve studies showing the effects of VR-based interventions on these transdiagnostic factors. 29 experimental studies and seven case-studies were selected. A total of 23 considered avoidance, eight dealt with emotion regulation, three concerned aggression, two addressed impulsivity, two dealt with cognitive reappraisal, and none examined disinhibition. Most of the studies included anxiety disorder patients (n = 15), especially with specific phobias (n = 8) and social anxiety disorder (n = 4). VR managed to improve all transdiagnostic factors, with results often maintained at follow-ups (n = 21 studies; range: 1–12 months) and similar to traditional interventions (e.g., cognitive-behavioral therapy). Exploring the transdiagnostic potential of VR may help to reduce costs and improve applicability in clinical psychology. While results were promising, further studies are needed for aggression, impulsivity and cognitive reappraisal, especially including follow-ups, comparisons with first-line treatments, and understudied clinical populations.

The association between cortisol-AA coordination in response to stress, negative urgency, and antisocial behavior in an urban adult sample

Prior study has found that the interplay of the hypothalamic-pituitary-adrenal (HPA) axis and the autonomic nervous system (ANS) influences behavior problems in youth. Yet, little is known regarding this relationship in adults and traits related to the coordination of the stress systems. This study aims to extend the findings of a youth sample that the coordination between HPA and ANS, measured as cortisol and alpha-amylase (AA) respectively, was associated with antisocial behavior in adults. Additionally, this study tests whether cortisol-AA coordination was associated with a conceptually relevant trait, negative urgency. A heterogeneous sample of 124 adults (college students, active offenders, and demographically matched controls) was recruited from a southern city. Participants filled out instruments for negative urgency and antisocial behavior, completed a modified Trier Social Stress Test (mTSST), and provided four saliva samples before and after mTSST to assay for cortisol and AA. Results showed that cortisol-AA stress coordination was stronger among offenders than other groups. Cortisol-AA stress coordination was also positively associated with antisocial behavior and with negative urgency. This study found support for the interpretation that cortisol-AA stress coordination may indicate an overshooting ANS response at high emotional distress, and highlight the importance of the multisystem approach in gaining new insights into behavior research.

When the UPPS-P Model of Impulsivity Meets a Revised Approach: The Development and Validation of the TRUE Multidimensional Impulsivity Scale

There is inconsistency in the measurement of impulsivity resulting from the diversity in its conceptualization. We aimed to develop a revised measure based on the Urgency, Premeditation (lack of), Perseverance (lack of), Sensation Seeking - Positive Urgency (UPPS-P) model (i.e., TRUE Multidimensional Impulsivity Scale; TRUE-MIS) considering the limitations and strengths of the existing measures. We conceptualized impulsivity as a personality trait referring to the inability to restrain one's urges without thinking about the future consequences in various contexts. A total of 535 adults (262 females, M = 34.1, SD = 12.7) participated in Study 1. Principal component analyses indicated a four-factor structure (internal urgency, social urgency, lack of premeditation, and lack of perseverance) with satisfactory internal consistency and validity evidence by significant relations with self-control. Confirmatory factor analysis in Study 2 confirmed the factor structure obtained in Study 1. Hierarchical linear regression analyses provided further validity evidence through establishing differential links between the subscales and Big Five personality traits, emotion regulation, depression, anxiety, and smartphone addiction in a sample of 556 adults (368 females, M = 24.0, SD = 7.4). Overall, TRUE-MIS is a valid and reliable measure of impulsivity addressing the arguments regarding the conceptual structure of the construct.

Dynamic Regulatory Processes in the Transition From Suicidal Ideation to Action in Adults Leaving Inpatient Psychiatric Care: Protocol for an Intensive Longitudinal Study

BACKGROUND

US suicide rates have risen steadily in the past decade, and suicide risk is especially high in the months after discharge from inpatient psychiatric treatment. However, suicide research has lagged in examining dynamic within-person processes that contribute to risk over time among individuals known to be at high risk of suicide. Almost no research has examined how affective, cognitive, and physiological processes change over minutes, hours, or days to confer risk of suicidal behavior in daily life.

OBJECTIVE

This protocol describes a longitudinal study designed to examine real-world changes in risk of suicide across multiple assessment domains. Specifically, the study involves following adults known to be at high risk of suicide after discharge from inpatient psychiatric care using self-report, interview, actigraphy, and behavioral methods to identify proximal contributors to suicidal thoughts and behaviors. First, we hypothesize that negative affective experiences, which are featured in most major suicide theories, will comprise a latent factor indicative of psychache (emotional pain), which will predict increases in suicidal thinking over time. Second, we hypothesize that poor inhibitory control in the context of negative affective stimuli, as well as emotion-related impulsivity, will predict the transition from suicidal thinking to suicidal behavior over time. Third, we hypothesize that short sleep duration will precede within-person increases in suicidal ideation as well as increased odds of suicidal behavior among those reporting suicidal thoughts.

METHODS

The desired sample size is 130 adults with past-week suicidal thoughts or behaviors who are receiving inpatient psychiatric treatment. Participants will complete a battery of measures while on the inpatient unit to assess negative affective experiences, emotion-related impulsivity, inhibitory control, typical sleep patterns, and relevant covariates. After discharge from inpatient care, participants will complete 4 weeks of signal-contingent ecological momentary assessment surveys, as well as mobile behavioral measures of inhibitory control, while wearing an actigraphy device that will gather objective data on sleep. Participants will complete interviews regarding suicidal thoughts and behaviors at 4 and 8 weeks after discharge.

RESULTS

The study was funded by the National Institutes of Health in November 2020. Recruitment began in April 2021. Data analysis will begin after completion of data collection.

CONCLUSIONS

This study will elucidate how affective, cognitive, and physiological risk factors contribute (or do not contribute) to within-person fluctuations in suicide risk in daily life, with important implications for extant theories of suicide. Of import, the examined risk factors are all modifiable; thus, the results will inform identification of key targets for just-in-time, flexible, personalized, digital interventions that can be used to decrease emotional distress and prevent suicide among those at highest risk.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/38582.

Gray matter volumetric correlates of dimensional impulsivity traits in children: Sex differences and heritability

Previous research investigated the cerebral volumetric correlates of impulsivity largely in moderate-sized samples and few have examined the distinct correlates of dimensions of impulsivity, sex differences, or heritability of the correlates. Here, we performed voxel-based morphometry analysis of data (n = 11,474; 5,452 girls, 9-10 years) curated from the Adolescent Brain Cognition Development project. In a linear regression with all five UPPS-P subscores as regressors and age in months, total intracranial volume, study site, and scanner model as covariates, higher levels of lack of premeditation, and sensation seeking were correlated with larger cortical and subcortical gray matter volumes (GMVs). In contrast, higher positive urgency was correlated with smaller GMVs in many of the same regions. The dimensional impulsivity traits also involved distinct volumetric correlates, with, for instance, sensation seeking and positive urgency specifically implicating bilateral caudate head/mid-cingulate cortex and bilateral lateral orbitofrontal cortex/left precentral gyrus, respectively. Boys relative to girls scored higher in all impulsivity dimensions. Girls relative to boys showed significantly stronger positive and negative correlations between sensation seeking and insula, putamen, and inferior frontal gyrus (IFG) GMVs and between positive urgency and cingulate cortex, insula, and IFG GMVs, respectively. With a subsample of twins, the dimensional impulsivity traits were weakly to moderately heritable in both girls and boys, and the GMV correlates were highly heritable in girls and boys combined. These findings collectively suggest shared and nonshared as well as sex differences in the cerebral volumetric bases of dimensional impulsivity traits and may facilitate research of externalizing psychopathology in children.

The factor structure of the Barratt Impulsiveness Scale (BIS-11) and correlates of impulsivity among outpatients with schizophrenia and other psychotic disorders in Singapore

BACKGROUND

Impulsivity has been linked to risky behaviours amongst patients with schizophrenia or other psychotic disorders. However, there is a dearth of studies examining impulsivity amongst this population in Singapore. Moreover, to date, scales to measure impulsivity have not been validated in this population. The present study seeks to examine the underlying factor structure of the Barratt Impulsiveness Scale (BIS-11) and explore sociodemographic and clinical correlates of impulsivity within this group.

METHODS

Confirmatory factor analyses (CFA) were conducted to test factor structures of the BIS-11 proposed in extant literature. However, due to poor fit statistics, the sample (n = 397) was split into two groups, with Exploratory Factor Analyses (EFA) conducted in the first subgroup (n = 200). The final model of the EFA was then tested within the second subgroup (n = 197) with CFA. Multivariable linear regressions were conducted to examine sociodemographic and clinical correlates of each underlying factor.

RESULTS

CFA indicated a three-factor structure amongst 16-items of the BIS-11 with acceptable fit: i) Non-planning impulsivity (5-items; α = 0.94), ii) Motor impulsiveness (6-items α = 0.84), and iii) Lack of self-control (5-items, α = 0.85). Lower education was associated with higher non-planning impulsivity. While age, ethnicity, marital status, and general psychiatric symptom severity were significant correlates of motor impulsiveness, problematic alcohol use and general psychiatric symptom severity were related to a greater lack of self-control.

CONCLUSION

Factor structures of the BIS-11 suggested by extant literature were not applicable, and we propose an alternative factor structure for BIS-11. Significant correlates of impulsivity are highlighted, and avenues for future research are suggested.

Emotion-related impulsivity predicts increased anxiety and depression during the COVID-19 pandemic

INTRODUCTION

Emotion-related impulsivity, defined by poor constraint in the face of emotion, is related to internalizing symptoms, cross-sectionally and longitudinally. Internalizing symptoms, though, are profoundly tied to stress reactivity, and little is known about how emotion-related impulsivity relates to stress reactivity.

METHOD

Taking advantage of a sample that had completed measures of depression, anxiety, suicidal ideation, and two forms of emotion-related impulsivity before the pandemic, we asked participants to complete three weekly follow-up internalizing assessments early in the pandemic.

RESULTS

Among the 150 participants, pre-pandemic emotion-related impulsivity scores predicted higher depression, anxiety, general distress, and suicidal ideation during the COVID-19 pandemic. Controlling for pre-pandemic scores, one form of emotion-related impulsivity (Feelings Trigger Action) predicted increased anxiety and general distress. We also examined how pre-pandemic emotion-related impulsivity was moderated by weekly COVID-related stress. One form of emotion-related impulsivity (Pervasive Influence of Feelings) predicted internalizing symptoms at low stress levels, and a different form (Feelings Trigger Action) predicted internalizing symptoms at higher stress levels.

LIMITATIONS

Limitations include the small sample size, the absence of repeat measures of impulsivity, the attrition of individuals with more internalizing symptoms, and the reliance on self-rated measures.

CONCLUSIONS

Forms of emotion-related impulsivity predict increases in anxiety and distress over time, but the interactions with stress levels appear to vary. Emotion-related impulsivity can be addressed with accessible intervention tools, suggesting the promise of broader screening for those at risk for internalizing symptoms during periods of high stress.

Distress tolerance across substance use, eating, and borderline personality disorders: A meta-analysis

BACKGROUND

Distress tolerance (DT) has received increased attention in recent years due to its purported role in dysregulated behaviours and their clinical manifestations, such as problematic substance use (PSU), disordered eating behaviours (e.g., binge-eating and purging; DEB), and borderline personality disorder (BPD) symptomatology. Despite the proposed transdiagnostic utility of DT across PSU, DEB, and BPD, there has yet to be a systematic and comprehensive examination characterising and comparing its association with this class of impulsive-type psychopathology.

METHODS

A systematic search was conducted across five electronic databases using search terms designed to capture extant literature on the association between DT and PSU, DEB, and BPD symptomatology. A series of meta-analyses were undertaken on correlation coefficients from 81 studies to examine the association between DT and each psychopathology domain, as well as impulsive-type psychopathology overall. Moderator analyses were conducted to examine whether these relationships were moderated by DT measurement type, sample type, age, and gender.

RESULTS

DT shared significant, negative, medium correlations with PSU (r = -.18,), DEB (r = -.20), and BPD symptomatology (r = -.27). The magnitude of these associations was not significantly different across the three psychopathology domains, supporting transdiagnostic conceptualisation. DT measurement type, age, and sample type moderated several of these indicated relationships.

LIMITATIONS

The majority of studies were conducted in adult samples from Western countries, limiting understanding of these relationships across development and different cultures.

CONCLUSIONS

The present findings support the putative transdiagnostic role of DT across PSU, DEB, and BPD, which may ultimately inform novel, cross-cutting interventions.

Emotion-related impulsivity: Testing a model of arousal effects on cognitive control

The trait-based tendency to respond rashly to emotions is robustly tied to many forms of psychopathology and poor behavioural outcomes, including aggression and suicidality. Researchers have found associations between response inhibition and emotion-related impulsivity; however, effect sizes are often small. Because emotion-related impulsivity emerges in the context of heightened positive and negative emotions, arousal is a candidate trigger of impulsivity. The goals of the present study were to (1) replicate the association between emotion-related impulsivity and response inhibition, and (2) test whether emotion-related impulsivity is associated with arousal-induced decays in response inhibition performance. Participants (N = 55) completed a self-report measure of emotion-related impulsivity, and then completed a computer-based response inhibition task (the antisaccade task, in which participants must make a rapid saccadic eye movement away from a cue rather than toward it) before and after a well-validated stress induction (the Trier Social Stress Test). Psychophysiological indices of arousal were measured throughout the session. Findings provide partial support for the association between emotion-related impulsivity and pre-stress response inhibition. Contrary to hypotheses, emotion-related impulsivity did not interact with arousal to predict post-stress response inhibition performance after controlling for pre-stress response inhibition performance. Future research is needed to consider clinical samples and to assess whether emotion-related impulsivity is related to deficits in other facets of cognitive control and decision-making.

Relationship between impulsivity, uncontrolled eating and body mass index: a hierarchical model

BACKGROUND

Impulsivity increases the risk for obesity and weight gain. However, the precise role of impulsivity in the aetiology of overeating behavior and obesity is currently unknown. Here we examined the relationships between personality-related measures of impulsivity, Uncontrolled Eating, body mass index (BMI), and longitudinal weight changes. In addition, we analyzed the associations between general impulsivity domains and cortical thickness to elucidate brain vulnerability factors related to weight gain.

METHODS

Students (N = 2318) in their first year of university-a risky period for weight gain-completed questionnaire measures of impulsivity and eating behavior at the beginning of the school year. We also collected their weight at the end of the term (N = 1177). Impulsivity was divided into three factors: stress reactivity, reward sensitivity and lack of self-control. Using structural equation models, we tested a hierarchical relationship, in which impulsivity traits were associated with Uncontrolled Eating, which in turn predicted BMI and weight change. Seventy-one participants underwent T1-weighted MRI to investigate the correlation between impulsivity and cortical thickness.

RESULTS

Impulsivity traits showed positive correlations with Uncontrolled Eating. Higher scores in Uncontrolled Eating were in turn associated with higher BMI. None of the impulsivity-related measurements nor Uncontrolled Eating were correlated with longitudinal weight gain. Higher stress sensitivity was associated with increased cortical thickness in the superior temporal gyrus. Lack of self-control was positively associated with increased thickness in the superior medial frontal gyrus. Finally, higher reward sensitivity was associated with lower thickness in the inferior frontal gyrus.

CONCLUSION

The present study provides a comprehensive characterization of the relationships between different facets of impulsivity and obesity. We show that differences in impulsivity domains might be associated with BMI via Uncontrolled Eating. Our results might inform future clinical strategies aimed at fostering self-control abilities to prevent and/or treat unhealthy weight gain.

Factors related to the dual condition of gambling and gaming disorders: A path analysis model

BACKGROUND AND AIMS

Gaming disorder has experienced rapid growth in the last decade among youth and adult populations, in parallel to the expansion of the videogame industry. The objective of this study was to explore the underlying process to explain the dual diagnosis of gaming with gambling disorder.

METHODS

The sample included n = 117 patients who met clinical criteria for gaming disorder, recruited from a tertiary care unit specialized in the treatment of behavioral addictions. Path analysis (implemented through structural equation modeling) assessed the direct and mediational mechanisms between the dual condition of gaming + gambling disorder and sociodemographic variables and personality traits.

RESULTS

The comorbid gaming + gambling disorder was met for 14.5% of the participants (additionally, 6.0% of the sample also met criteria for problematic gambling). The dual diagnosis was directly related to an older age at onset of the addiction problems, a higher level of the novelty seeking trait and being in active work. Employment status also mediated the relationship between persistence levels and chronological age. Greater psychopathological distress was related to females, higher levels of harm avoidance and persistence and lower levels of self-directedness.

CONCLUSIONS

The results of this study provide empirical evidence for the specific factors that increase the likelihood of the dual gaming + gambling disorder. Clinical settings should consider these features to improve gaming diagnosis and treatment. Preventive programs should also be focused on the most vulnerable groups to prevent onset and progression of this comorbid condition.

Exploring the Link Between Transdiagnostic Cognitive Risk Factors, Anxiogenic Parenting Behaviors, and Child Anxiety

Theoretical models suggest parent anxiety leads to increased anxiogenic parenting, an important etiological factor for child anxiety disorders. Evidence suggests that parents engage in anxiogenic parenting to reduce distress in response to their child's anxiety; however, further study of this mechanism is needed. Cognitive risk factors, including distress intolerance, anxiety sensitivity, emotion-related impulsivity, and repetitive negative thinking are promising to examine as they impact emotion regulation. This study examined whether an indirect association between parent anxiety and anxiogenic parenting via these risk factors exists, and if child anxiety moderated this effect. Findings demonstrated evidence for an indirect association via distress intolerance in mothers at high levels of child anxiety, but not low levels. An unmoderated indirect effect via emotion-related impulsivity was found. Anxiety sensitivity and repetitive negative thinking did not demonstrate significant indirect effects. These findings suggest distress intolerance and emotional-related impulsivity may be targets for parent-focused child anxiety treatments.

Sleep and circadian rhythm actigraphy measures, mood instability and impulsivity: A systematic review

The normal spectrum trait measures of mood instability and impulsivity are implicated in and comprise core symptoms of several psychiatric disorders. A bidirectional relationship between these traits and sleep disturbance and circadian rhythm dysfunction has been hypothesised, although has not been systematically assessed using objective measures in naturalistic settings. We systematically reviewed the literature following PRISMA guidelines, according to a pre-registered protocol (PROSPERO: CRD 42018108213). Peer-reviewed quantitative studies assessing an association between actigraphic variables and any measure of mood instability or impulsivity in participants aged 12-65 years old were included. Studies were critically appraised using the AXIS tool. Twenty-three articles were retained for inclusion. There was significant heterogeneity in the selection and reporting of actigraphic variables and metrics of mood instability and impulsivity. We identified emerging evidence of a positive association between circadian rest-activity pattern disturbance and delayed sleep timing with both mood instability and impulsivity. Evidence for an association with sleep duration, sleep efficiency or sleep quality was inconsistent. Future research should focus on longitudinal intra-individual associations to establish the directionality between these measures and may lead to the development of chronotherapeutic interventions for a number of psychiatric disorders.

Momentary dynamics of emotion-based impulsivity: Exploring associations with dispositional measures of externalizing and internalizing psychopathology

Emotion-based impulsivity has emerged as an important transdiagnostic risk factor for both internalizing and externalizing psychopathology. However, it is unclear how this dynamic process unfolds within individuals. We measured urgency within-persons as the momentary association between impulsivity and contemporaneous negative and positive affect in 4 ecological momentary assessment samples (N = 233[16,202 observations]; N = 302[11,360]; N = 311[17,517]; N = 291[20,297]) that span clinical, community, and student populations. Based on reflexive responding to emotion (RRE) and urgency frameworks, we hypothesized a) that significant individual differences in the dynamic association between affect and impulsivity would emerge, and b) that individual differences in positive and negative urgency pathways would be associated with externalizing and internalizing psychopathology. Within-person associations between negative affect and impulsivity consistently emerged; however, the association between positive affect and impulsivity was inconsistent across samples. Although average effects were small, significant individual differences existed in both urgency pathways. Consistent with prior studies, within-person urgency pathways were unassociated with global or dispositional measures of impulsivity. Contrary to expectation, within-person urgency was also unassociated with between-person measures of either internalizing or externalizing psychopathology. Yet, robust associations were seen between the same measures and average levels of momentary impulsivity and negative affect. We discuss results in terms of their relevance to both urgency and RRE frameworks and propose future directions to help disentangle emotion-based impulsivity and psychopathology in the moment. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Incipient alcohol use in childhood: Early alcohol sipping and its relations with psychopathology and personality

Prior research has shown that sipping of alcohol begins to emerge during childhood and is potentially etiologically significant for later substance use problems. Using a large, community sample of 9- and 10-year-olds (N = 11,872; 53% female), we examined individual differences in precocious alcohol use in the form of alcohol sipping. We focused explicitly on features that are robust and well-demonstrated correlates of, and antecedents to, alcohol excess and related problems later in the lifespan, including youth- and parent-reported externalizing traits (i.e., impulsivity, behavioral inhibition and activation) and psychopathology. Seventeen percent of the sample reported sipping alcohol outside of a religiously sanctioned activity by age 9 or 10. Several aspects of psychopathology and personality emerged as small but reliable correlates of sipping. Nonreligious sipping was related to youth-reported impulsigenic traits, aspects of behavioral activation, prodromal psychotic-like symptoms, and mood disorder diagnoses, as well as parent-reported externalizing disorder diagnoses. Religious sipping was unexpectedly associated with certain aspects of impulsivity. Together, our findings point to the potential importance of impulsivity and other transdiagnostic indicators of psychopathology (e.g., emotion dysregulation, novelty seeking) in the earliest forms of drinking behavior.

Distress Tolerance as a Mechanism Linking Violence Exposure to Problematic Alcohol use in Adolescence

Adolescents exposed to violence are at elevated risk of developing most forms of psychopathology, including depression, anxiety, and alcohol abuse. Prior research has identified emotional reactivity and difficulties with emotion regulation as core mechanisms linking violence exposure with psychopathology. Scant research has examined behavioral responses to distress as a mechanism in this association. This study examined the association of violence exposure with distress tolerance-the ability to persist in the face of distress-and whether lower distress tolerance linked violence exposure with subsequent increases in depression, anxiety, and alcohol abuse problems during adolescence. Data were collected prospectively in a sample of 287 adolescents aged 16-17 (44.3% male; 40.8% White). At Time 1, participants provided self-report of demographics, violence exposure, and psychopathology, and completed a behavioral measure of distress tolerance, the Paced Auditory Serial Addition Task. Four months later, participants (n = 237) repeated the psychopathology assessments. Violence exposure was associated with lower distress tolerance (β = -.21 p = .009), and elevated concurrent psychopathology (β = .16-.45, p = .001-.004). Low distress tolerance was prospectively associated with greater likelihood of abusing alcohol over time (OR = .63, p = .021), and mediated the association between violence exposure and greater levels (β = .02, 95% CI [.001, .063]) and likelihood (OR = .03, 95% CI [.006, .065]) of alcohol use over time. In contrast, low distress tolerance was not associated concurrently or prospectively with internalizing symptoms. Results persisted after controlling for socio-economic status. Findings suggest that distress tolerance is shaped by early experiences of threat and plays a role in the association between violence exposure and development of problematic alcohol use in adolescence.

Association patterns of cannabis abuse and dependence with risk of problematic non-substance-related dysregulated and addictive behaviors

Co-occurrence of drug misuse with other dysregulated behaviors is common. This study was aimed at exploring the associations between the risk of presenting a clinically relevant condition involving non-substance-related addictive or dysregulated behaviors (as measured by the MultiCAGE CAD-4 screening), and cannabis abuse/dependence (CAST/SDS) scores, and the role of gender therein. Participants were recruited using stratified probabilistic sampling at the University of Granada. Mann-Whitney’s U tests were used to compare male and female students in SDS and CAST scores. Associations between gender and MultiCAGE scores were estimated using the γ ordinal correlation index, and tested with χ². For each MultiCAGE dimension, a Poisson-family mixed-effects model was built with either SDS or CAST as the main input variable, while controlling for nicotine and alcohol dependence, and relevant sociodemographic variables. Incidence rate ratios (IRR) were computed for SDS/CAST effects, and the significance threshold was family-wise Bonferroni-corrected. Gender differences were significant for cannabis dependence/abuse and all MultiCAGE scores for non-substance-related conditions, with males showing higher risk scores for excessive gambling, excessive internet use, excessive video gaming, and hypersexuality, and females presenting higher scores in dysregulated eating and compulsive buying. Cannabis dependence and abuse were significantly associated with a higher risk of problematic video gaming. These associations were mostly driven by males. Importantly, although risk of problematic video gaming was specifically associated with cannabis abuse/dependence, there was only a weak non-significant association between problematic video gaming and alcohol use scores. Risk of alcohol use problems, in turn, was strongly associated with all other non-substance-related problems (problematic gambling, excessive Internet use, dysregulated eating, compulsive buying, and hypersexuality). These differential associations can cast light on the etiological similarities and dissimilarities between problematic substance use and putative addictive behaviors not involving drugs.

A multi-method examination of the link between obsessive-compulsive symptomatology and emotion-related impulsivity

OBJECTIVES

Obsessive-compulsive disorder (OCD) is a condition marked by recurrent and distressing thoughts, images, and urges accompanied by repetitive physical or mental rituals. An emerging line of work suggests that emotion may be an important consideration when looking at the role of impulsivity across the spectrum of psychopathology, including OCD. The current study examined the relationship between obsessive-compulsive symptomatology (OCS) and impulsive cognitive and behavioural reactions to emotion using a multi-study, multi-method approach.

DESIGN

Data were collected cross-sectionally online (Study 1) or via an in-person laboratory visit (Study 2).

METHODS

In Study 1, self-report measures of impulsivity and OCS were administered to a large, non-selected community sample (N = 386). Study 2 extended these findings with a young adult sample (N = 107) with clinically elevated OCS using self-report measures, clinical interview, and two behavioural symptom provocation tasks.

RESULTS

Emotion-related impulsivity, but not non-emotion-related impulsivity, was associated with greater severity of OCS across symptom domains and across all modes of assessment. Impulsive cognitive responses to emotion were associated with greater obsession severity, while impulsive behavioural reactions to emotion were associated with greater compulsions. Emotion-related impulsivity also acted synergistically with a belief in the importance and control of thoughts, such that this established risk factor for OCD was associated with greater OCS severity only when behavioural reactivity to emotion was also present.

CONCLUSIONS

Results highlight the importance of considering emotional context when studying impulsivity in OCD, and point to the potentially differential relationship between OCS and behavioural versus cognitive impulsive reactions to emotion.

PRACTITIONER POINTS

Emotion-related impulsivity (ERI) reflects a tendency to act impulsively in the context of strong emotions. ERI was associated with greater OCS across symptom domains and type of symptom assessment (self-report, interview, or symptom provocation). ERI also interacted with an established OCS risk factor, a belief in the importance and control of thoughts, to predict symptom severity, suggesting that it may be important to evaluate and address ERI alongside unhelpful beliefs in patients with OCS. Given the present study's cross-sectional nature, we cannot draw conclusions about the directionality of the ERI - OCS relationship, and while our study included individuals with clinically elevated OCS, results should be replicated in a fully clinical sample.

Effects of tDCS during inhibitory control training on performance and PTSD, aggression and anxiety symptoms: a randomized-controlled trial in a military sample

BACKGROUND

Post-traumatic stress disorder (PTSD), anxiety, and impulsive aggression are linked to transdiagnostic neurocognitive deficits. This includes impaired inhibitory control over inappropriate responses. Prior studies showed that inhibitory control can be improved by modulating the right inferior frontal gyrus (IFG) with transcranial direct current stimulation (tDCS) in combination with inhibitory control training. However, its clinical potential remains unclear. We therefore aimed to replicate a tDCS-enhanced inhibitory control training in a clinical sample and test whether this reduces stress-related mental health symptoms.

METHODS

In a preregistered double-blind randomized-controlled trial, 100 active-duty military personnel and post-active veterans with PTSD, anxiety, or impulsive aggression symptoms underwent a 5-session intervention where a stop-signal response inhibition training was combined with anodal tDCS over the right IFG for 20 min at 1.25 mA. Inhibitory control was evaluated with the emotional go/no-go task and implicit association test. Stress-related symptoms were assessed by self-report at baseline, post-intervention, and after 3-months and 1-year follow-ups.

RESULTS

Active relative to sham tDCS neither influenced performance during inhibitory control training nor on assessment tasks, and did also not significantly influence self-reported symptoms of PTSD, anxiety, impulsive aggression, or depression at post-assessment or follow-up.

CONCLUSIONS

Our results do not support the idea that anodal tDCS over the right IFG at 1.25 mA enhances response inhibition training in a clinical sample, or that this tDCS-training combination can reduce stress-related symptoms. Applying different tDCS parameters or combining tDCS with more challenging tasks might provide better conditions to modulate cognitive functioning and stress-related symptoms.

Latent profile analysis of impulsivity and perfectionism dimensions and associations with psychiatric symptoms

BACKGROUND

Impulsivity and perfectionism are transdiagnostic personality factors that have been studied extensively and shown to relate to externalizing and internalizing pathology respectively. Typically, these personality factors are antithesized, with impulsivity characterized by lack of control and perfectionism characterized by rigid overcontrol.

METHODS

The current study (N = 1,353 undergraduate students) used latent profile analysis to identify subgroups based on impulsivity and perfectionism dimensions and tested the relations of these subgroups with the symptomatology of ten prevalent types of psychopathology (depression, worry, social anxiety, attention-deficit hyperactivity disorder inattentive subtype, attention-deficit hyperactivity disorder impulsive-hyperactive subtype, alcohol use, obsessive-compulsive disorder, posttraumatic stress disorder, restrictive eating pathology, and binge eating pathology).

RESULTS

The latent profile analysis identified four meaningful subgroups: high perfectionism, high impulsivity, combined impulsivity and perfectionism, and low impulsivity and perfectionism. The combined group was the most prevalent, comprising almost half of the sample. Further, the perfectionism group had the highest scores for obsessive-compulsive disorder, worry, and restrictive eating pathology, the impulsivity group had the highest scores for alcohol use disorder, and the combined group had the highest or second-highest scores across all types of psychopathology.

LIMITATIONS

Limitations include the undergraduate sample, self-report, cross-sectional study design, and high bivariate residuals.

CONCLUSIONS

These findings suggest impulsivity and perfectionism can co-occur. Further, the co-occurrence of these personality traits may heighten risk for psychopathology and help explain comorbidity across internalizing and externalizing disorders. Future research should continue to investigate the presentation, prevalence, and treatment for individuals high in both perfectionism and impulsivity.

Micro Versus Macro Processes: How specific stress exposure impacts sleep, affect, and risk-related behavior on the path to disease in high-risk adults

BACKGROUND

The stress-to-disease association has been well-accepted for some time. However, the understanding of how stress exposure contributes to psychological disease progression remains unclear.

OBJECTIVE

To test the real-time impact of variable stress exposure on risk-related clinical phenomena and affective disease progression in a high-risk sample of active-duty firefighters.

METHODS

Participants completed weekly diaries reporting stressful event exposure, affect, sleep, and risk-related and healthy behaviors over six-months and were evaluated for lifetime and current psychiatric disease using clinical interviews before and after the sampling period.

RESULTS

Stress exposure impacted clinical phenomena in differing ways. Major personal events and day-to-day hassles predicted health-impairing shifts in sleep and behavior that were associated with increases in symptoms and psychological distress over the 6-month period. In contrast, highly aversive incidents predicted greater adaptive behaviors that were uniquely predictive of symptom decreases over the six-month period.

CONCLUSION

These findings shed new light on stress-to-disease processes, demonstrating how variable stress exposure influences critical shifts in behavior and sleep, contributing to psychological adjustment of firefighters over time. These data suggest practical ways to monitor risk in high-risk samples (e.g., monitoring sleep latency) and offer avenues for further explication of disease processes in real time.

Cross-Study, Cross-Method Associations Between Negative Urgency and Internalizing Symptoms

There is a small body of research that has connected individual differences in negative urgency, the tendency to report rash actions in response to negative emotions, with self-report depressive and anxiety symptoms. Despite the conceptual overlap of negative urgency with negative emotionality, the tendency to experience frequent and intense negative emotions, even fewer studies have examined whether the association of negative urgency with internalizing symptoms hold when controlling for negative emotionality. In the current study, we estimated the bivariate association between negative urgency and internalizing symptoms, tested whether they remained significant after partialling out negative emotionality, and tested whether these effects generalized to real-time experiences of negative emotions. We used data from five independent samples of high school and college students, assessed with global self-report (n = 1,297) and ecological momentary assessment (n = 195). Results indicated that in global self-report data, negative urgency was moderately and positively associated with depressive and anxiety symptoms, and the partial association with depressive symptoms (but not anxiety symptoms) controlling for negative emotionality remained significant and moderate in magnitude. This pattern was replicated in ecological momentary assessment data. Negative urgency may convey risk for depressive symptoms, independent of the effects of negative emotionality.