Reliability and validity of the Italian translation of the UPPS-P Impulsive Behavior Scale in a sample of consecutively admitted psychotherapy patients

Psychometric Properties and Normative Data of the Spanish UPPS-P Impulsive Behavior Scale in Adolescents

Impulsivity is a multidimensional construct linked to a broad spectrum of psychopathological and neuropsychological disorders. The UPPS-P model has emerged as a valuable tool for assessing impulsivity from a multi-dimensional perspective. Despite its relevance, few studies have examined the psychometric properties of the UPPS-P scale scores in a large, representative sample of adolescents. This study aims to evaluate the psychometric properties of the Spanish UPPS-P in adolescents and to establish normative data for this population in Spain. To this end, 9024 students aged 11-19 from 66 different Spanish high schools were included. The fit for the expected 5-factor model, assessed through confirmatory factor analysis, was inadequate (CFI and TLI ≤ .85, RMSEA = .063), but becomes satisfactory when employing the more flexible ESEM approach (CFI and TLI ≥ .94, RMSEA = .038), which was invariant across gender and age. Internal consistency reliability was satisfactory (ω = .83 to .94). Convergent validity with the Barratt Impulsiveness Scale-11-A total score was good (r = .53 to .60). We provide population norms of the UPPS-P, which may help practitioners to interpret the UPPS-P scores of adolescents from the general population in Spain. Subsequent research should explore implications for both clinical and non-clinical settings.

Dissociative Dimensions and Their Implications for Emotional Dysregulation Underlying Borderline Personality Disorder Features

ABSTRACT

Emotion dysregulation is considered a core feature of borderline personality disorder (BPD). The role of dissociation in BPD has been discussed from different perspectives. Nevertheless, implications of dissociation for BPD features are not clear. The current study estimated mediation effects of dissociative dimensions on the relationships between several emotion regulation strategies (ERSs) and BPD features among 281 adults recruited from the general population. The online survey administered a comprehensive self-report battery for the assessment of maladaptive and adaptive ERSs together with dissociative dimensions. Borderline personality disorder features were also self-report screened. Results showed significant indirect effects of dissociation on the relationships between ERSs and BPD features. Dissociation was a full mediator of the relationship between deficits with problem-solving skills and BPD criteria. The study confirmed that emotion dysregulation is a core feature of BPD and that the dissociative dimensions should be included as relevant maladaptive mechanisms sustaining BPD emotional difficulties.

The Complexity of Impulsivity Dimensions among Abstinent Individuals with Substance Use Disorders

Impulsivity is a complex construct that has been operationalized considering personality dimensions (e.g., negative urgency [NU], lack of perseverance [LPe], lack of premeditation [LPr], positive urgency [PU]), and neuropsychological processes (i.e., cognitive disinhibition, motor disinhibition, impulsive decision-making). Empirical research suggested that they could represent core features of substance use disorders (SUDs). However, there are no studies that have comprehensively assessed them among patients with SUDs. Furthermore, the quality of relationships among such domains remains unclear. The current case-control study included 59 abstinent patients with SUDs and 56 healthy controls (HCs). There were two independent assessment phases: i) the administration of UPPS-P impulsive behavior scale; ii) a computerized neuropsychological battery (i.e., Attentional Network Test, Go/No-Go task, Iowa Gambling task). Patients with SUDs reported higher levels of NU and PU than HCs. NU, LPe, and LPr were associated to the co-occurrence of multiple SUDs. Motor disinhibition was the core dimension of SUDs. Cognitive disinhibition and Impulsive decision-making were also associated to SUDs. Self-report and neuropsychological dimensions of impulsivity were not correlated within the clinical group. HCs showed significant associations among these domains of impulsivity. Impulsivity should be viewed as a complex system of personality traits and neuropsychological processes among individuals with SUDs.

The Initial Efficacy of Stand-Alone DBT Skills Training for Treating Impulsivity Among Individuals With Alcohol and Other Substance Use Disorders

Impulsivity is considered a core feature of substance use disorders (SUDs), including personological (i.e., negative urgency, positive urgency, lack of premeditation) and neuropsychological (i.e., cognitive and motor disinhibition, impulsive choice) dimensions. Dialectical Behavior Therapy Skills Training (DBT-ST) as a stand-alone treatment is an effective intervention for alcohol use disorder (AUD) and other SUDs. However, there are no studies that have investigated changes in impulsivity levels during a DBT-ST program, especially testing the therapeutic effects of DBT skills. Twenty-nine patients with AUD and other SUDs were admitted to a 3-month DBT-ST program. Self-report (i.e., UPPS-P) and computerized neuropsychological (i.e., Attentional Network test; Go/No-Go task; Iowa Gambling Task) measures of impulsivity were administered at the beginning and end of the DBT-ST. Distress tolerance (DTS), mindfulness (MAAS, FFMQ) and emotion regulation (DERS) were also assessed pre- and post-intervention. The study included two age- and gender-matched control groups: (a) untreated patients with SUDs (N = 29); (b) healthy controls (HCs) (N = 29). Twenty-four (82.7%) patients concluded the DBT-ST program. Emotion-based forms of impulsivity significantly improved during the program. At the end of treatment, impulsivity levels were significantly lower than those of untreated patients with SUDs and they were not significantly different from HCs. Cognitive disinhibition significantly decreased during the treatment. The improvement in impulsivity was explained by pre- posttreatment changes in distress tolerance, mindfulness and emotion regulation. Motor disinhibition did not improve during the treatment. These findings supported the initial efficacy of the DBT-ST program for addressing different features of impulsivity among individuals with AUD and other SUDs. Future follow-up studies should demonstrate the role of impulsivity domains in long-term relapse prevention.

Are problem buying and problem gambling addictive, impulsive, or compulsive in nature? A network analysis and latent dimension analysis study in Italian community-dwelling adults

Prominent scholars suggested that the impulsive-obsessive compulsive continuum may represent a framework to understand both substance and behavioral addictions. However, the characterization of pathological buying (PB) and problem gambling (PG) within the compulsive-impulsive spectrum has not been extensively investigated. To explore the relationships among PB, PG, alcohol and substance abuse, DSM-5 obsessive-compulsive and related disorders, and impulsive dimensions, a sample of 1,005 Italian community-dwelling adult participants (55.5% female), was administered self-reported measures of PB, PG, and other theoretically-relevant constructs. We expected to observe a multidimensional structure in our data; moreover, DSM-5 obsessive compulsive and related disorders were hypothesized to be accounted for by a common dimension. Three dimensions were identified and replicated across two different, non-redundant methods (i.e., exploratory graph analysis and exploratory factor analysis), namely, substance use and gambling, obsessive and compulsive phenomena, and impulsivity dimensions. Specifically, PG seemed to represent a behavioral variant of addiction vulnerability, PB seemed more akin to obsessive-compulsive spectrum disorders, and disinhibition dimension represented the common core of negative urgency, lack of premeditation, lack of perseverance, sensation seeking (SS), and positive urgency. Our findings may be helpful in improving our knowledge on the similarities and differences between PB and PG.

Impulsivity and eating disorders: The relationship between serum 25-hydroxyvitamin D and different impulsivity facets in a transdiagnostic sample

OBJECTIVES

Eating disorders (EDs) are severe psychiatric conditions characterised by malnutrition, dysfunctional behaviours, and hypovitaminosis D. In various psychiatric conditions, including EDs, preliminary evidence has correlated impulsivity to a low level of 25-hydroxyvitamin D [25(OH)D]. This study aims to reinforce this evidence by examining different facets, both behavioural and psychological, of the impulsivity construct in patients with ED.

METHODS

A sample of 119 women was evaluated with a validated questionnaire and computerised neuropsychological tasks: the UPPS-P impulsive behaviour scale, a go/no-go task, and the Balloon Analogue Risk Task (BART). A clinical evaluation for EDs and blood sample collection were also performed to assess specific psychopathology and determine the serum level of 25(OH)D.

RESULTS

Significant correlations were found between serum levels of 25(OH)D and BART scores (p = 0.012) and lack of perseverance (p = 0.034). Moreover, regression analyses showed that higher BART scores may be explained by hypovitaminosis D and higher levels of lack of perseverance in patients with EDs.

CONCLUSIONS

The specific aspect of impulsivity linked to goal strategy and behaviours may be explained in patients with EDs by hypovitaminosis D. A possible connection to the brain inflammatory system is also discussed, along with possible directions for future research.

A Multi-Faceted Evaluation of Impulsivity Traits and Early Maladaptive Schemas in Patients with Anorexia Nervosa

(1) Background: patients with Anorexia Nervosa (AN) are classified either as restrictive (ANr) or binge/purge (ANbp) according to the absence or presence of impulsive eating and compensatory behaviors. The aim of the present study was to assess the levels of impulsivity in both AN subtypes and to explore whether individual differences in impulsivity may be explained by differences in the presence of early maladaptive schemas. (2) Methods: the sample group included 122 patients with ANr, 112 patients with ANbp, and 131 healthy women (HW). All of these participants completed the UPPS-P scale for an assessment of impulsive behaviors and the Young Schema Questionnaire (YSQ-S3) for an assessment of early maladaptive schemas. (3) Results: the patients with ANbp displayed higher levels of impulsivity compared with the patients with ANr and HW. Patients with AN, especially the restrictive subtype, also reported higher levels of early maladaptive schemas than HW, and regression analyses revealed that specific maladaptive schemas partially explain the variability in impulsivity in both patients and HW. (4) Conclusions: it appears that maladaptive beliefs developed during childhood or adolescence may predict the development of impulsivity, a personality trait usually associated with maladaptive behaviors, and appears to be prevalent among ANbp patients. The clinical effects of this, as well as directions for future study, are also discussed in this paper.

Psychometric properties of the short UPPS-P scale in adolescents: Gender, age invariance, and validity among italian youth

Impulsivity is a multifaceted construct associated with poor planning skills, difficulty in maintaining attention, and behavioral disinhibition-especially in conditions of highly activated affective states. Impulsivity plays a prominent role in adolescents, in whom high levels of impulsivity expose them to a greater risk of exhibiting risky behaviors or developing pathological conditions. Currently, one of the most popular frameworks to explain and assess impulsivity is the UPPS-P, which distinguishes between five impulsivity components, and from which the UPPS-P Scale and its short form are derived. In light of the relatively low number of psychometric analyses of the scale in adolescents, this study aimed to verify the psychometric properties of the Short UPPS-P Scale among Italian adolescents. The participants were 647 adolescents (68% males, mean age = 16.9, SD = 1.1 years). Confirmatory factor analysis supported the five-factor model of the scale, which was found to be invariant across gender and age and to have had good internal consistency values. Gender and age differences were also investigated. Evidence for validity was provided by supporting relationships between specific UPPS dimensions, gambling frequency, problem gambling, and problematic use of social networks. Overall, the findings showed that the Short UPPS-P Scale is a promising instrument to assess the multidimensional construct of impulsivity in adolescents in both research and clinical practice.

The role of self-monitoring metacognition sub-function and negative urgency related to binge severity

OBJECTIVE

This study aims to test a model where low self-monitoring (a sub-function of first-person domain of metacognition) and high negative urgency lead to a worsening of binge severity through the mediation of emotional dysregulation in patients with binge eating disorder (BED).

METHOD

Forty non-BED-obese and 46 BED-obese patients completed a battery of tests assessing metacognition and psychopathology. To test our hypothesized model, a structural equation model (SEM) using maximum likelihood estimation was conducted.

RESULTS

BED-obese patients had significantly higher scores in BES, UPPS-P Negative urgency, and DERS total score, and lower MSAS self-monitoring than non-BED-obese, while no differences emerged in the MSAS others-monitoring subscale. The structural model demonstrated very good fit indexes (χ² = 1.377, df = 2; p = .502, CMIN/DF = 0.688, CFI = 1.000, RMSEA = 0.000, TLI = 1.047) and all paths were significant in the predicted directions.

CONCLUSIONS

These preliminary findings show that, low self-monitoring and high negative urgency lead BED-obese patients to express the worsening of binge severity through the mediation of emotional dysregulation. This knowledge may be helpful in the clinical practice to develop a tailor-made treatment. Accordingly, an approach through Metacognitive Interpersonal Therapy could be attempted in BED-obese patients with these characteristics. Highlights Patients with BED exhibited low self-monitoring and high negative urgency. Binge severity was mediated by high level of emotional dysregulation. Metacognitive Interpersonal Therapy may be useful for BED patients.

Psychometric Properties of the Chinese version of UPPS-P Impulsive Behavior Scale

OBJECTIVE

The present study aimed to assess the psychometric properties of a Chinese version of the UPPS-P Impulsive Behavior Scale. The associations between the UPPS-P scale and impulsivity choice, gender, smoking, and drinking status were also assessed.

METHODS

A total of 127 adults ranging from 21 to 65 years old participated in the study. Participants were administered with the Chinese version of the UPPS-P Impulsive Behavior Scale, Beck Depression Inventory II (BDI-II), and State-Trait Anxiety Inventory (STAI). Impulsivity choice tasks were also tested including the Delay Discounting Task (DDT), Balloon Analogue Risk Task (BART), and Beads Task (Beads).

RESULTS

A new version of the UPPS-P Impulsive Behavior Scale was formed that includes 40 items. The scores of the UPPS-P Impulsive Behavior Scale demonstrated adequate internal consistency on five subscales but less sufficient structure validity in the present sample. In addition, positive urgency was negatively related to the Beads task; negative urgency and positive urgency were positively related to the DDT and BART. Moreover, positive and negative urgency were positively correlated with depression; all five subscales were positively correlated with anxiety; sensation seeking was higher in males than females and in alcohol drinkers than non-drinkers; and lack of premeditation and lack of perseverance were higher in nonsmokers than smokers.

CONCLUSIONS

The present study supports the reliability but not the structure validity of the UPPS-P Impulsive Behavior Scale. The impulsivity personality trait assessed by the UPPS-P scale was associated with impulsivity choice, depression, anxiety, gender, and drinking and smoking status. Further studies should be conducted to explore the structure of impulsivity in the Chinese population.

Psychometric Properties of the Chinese SUPPS-P Impulsive Behavior Scale: Factor Structure and Measurement Invariance Across Gender and Age

Objective: Impulsivity is widely recognized as a risk factor for a variety of mental disorders and problematic behaviors. The Short UPPS-P Impulsive Behavior Scale (SUPPS-P) is an extensively used instrument to measure impulsivity in research and clinical settings. The current study primarily aimed to evaluate the psychometric properties of the Chinese version of the SUPPS-P (C-SUPPS-P) among Chinese adolescents and emerging adults, and then to test its measurement invariance across gender and age. Methods: Data were collected from three vocational high schools and six colleges in Changsha, China. A total of 2,551 participants (20.1% male and 22.6% adolescents) completed the C-SUPPS-P and scales assessing addictive and problematic smartphone use, as well as emotional symptoms (anxiety, stress, depression). Four alternative models were examined and compared by using confirmatory factor analysis to determine the best factor structure of the C-SUPPS-P. Multigroup confirmatory factor analyses were used to test measurement invariance across gender and age. Results: A theory-driven five-factor structure consistent with the original scale was identified. All of the subscales had good internal consistency. The correlations observed with the other scales supported the construct validity of the C-SUPPS-P. Full measurement invariance was established across gender and age, and significant gender and age differences according to impulsivity facets were identified. Conclusions: The C-SUPPS-P presents a consistent factor structure, as well as reliability and validity that are equivalent to those of the original scale. The full measurement invariance shown across gender and age allows for intergroup comparisons. Overall, the C-SUPPS-P is a promising instrument to measure various impulsivity traits in Chinese adolescents and emerging adults.

Impulsivity Derived From the Dark Side: Neurocircuits That Contribute to Negative Urgency

Negative urgency is a unique dimension of impulsivity that involves acting rashly when in extreme distress and impairments in inhibitory control. It has been hypothesized to derive from stress that is related to negative emotional states that are experienced during the withdrawal/negative affect stage of the addiction cycle. Classically, a transition to compulsive drug use prevents or relieves negative emotional states that result from abstinence or stressful environmental circumstances. Recent work suggests that this shift to the "dark side" is also implicated in impulsive use that derives from negative urgency. Stress and anxious, depressed, and irritable mood have high comorbidity with addiction. They may trigger bouts of drug seeking in humans via both negative reinforcement and negative urgency. The neurocircuitry that has been identified in the "dark side" of addiction involves key neuropeptides in the central extended amygdala, including corticotropin-releasing factor. The present review article summarizes empirical and conceptual advances in the field to understand the role of the "dark side" in driving the risky and detrimental substance use that is associated with negative urgency in addiction.

The Psychology of Smartphone: The Development of the Smartphone Impact Scale (SIS)

Smartphones are changing lives in a number of ways. However, the psychological literature has primarily focused on smartphone overuse, neglecting the impacts that are not strictly related to problematic use. The present research was aimed to develop a comprehensive self-report scale that accounts for the cognitive, affective, social, and behavioral impacts of smartphones in everyday life-the Smartphone Impact Scale (SIS). Study 1 (N = 407) yielded a preliminary version of the scale, which was refined in Study 2 (N = 601). The SIS is a 26-item scale that measures seven dimensions of smartphone impact. Results revealed meaningful associations between its subscales, psychosocial constructs, and daily usage of smartphones and apps. The SIS broadens the view of human-smartphone interaction by extending the concept of problematic smartphone use to further dimensions (e.g., emotion regulation) and introducing a proper measurement of underinvestigated smartphone impacts (e.g., tasks support). The implications of each SIS subscale are discussed.

Recommendations for applying a multi-dimensional model of impulsive personality to diagnosis and treatment

The UPPS-P Model of Impulsive Personality, a prominent model of impulsive personality derived from the Five Factor Model of Personality, is a multi-dimensional model of impulsive personality that consists of negative urgency, lack of premeditation, lack of perseveration, sensation seeking, and positive urgency. The UPPS-P model has highlighted the importance of separating multidimensional traits due to the specificity of these traits corresponding to different risk behaviors. The goal of the current review paper is to make recommendations on how to apply the UPPS-P Model of Impulsive Personality, to diagnosis of and treatment for psychopathology. However, despite impulsivity being one of the most frequently used criteria for a number of clinical disorders, our review of the Diagnostic and Statistical Manual for Mental Disorders-5 found that the UPPS-P traits are not well represented in the diagnostic criteria, which we propose limits inferences about etiology and treatment targets. Additionally, research has largely focused on the importance of these traits for risk models; our review of the literature applying the UPPS-P traits to treatment processes and outcomes concluded that this area is not yet well studied. Here, we propose the specific application of the UPPS-P model to improve diagnosis and increase treatment effectiveness.