Risky decision-making after exposure to a food-choice task in excess weight adolescents: Relationships with reward-related impulsivity and hunger

Extreme weight conditions impact on the relationship between risky decision-making and interoception

Anorexia nervosa (AN) and obesity (OB) lie on the two ends of the broad spectrum of extreme weight conditions (EWC). Both disorders entail the constant risk to one's body integrity. Importantly, risk-taking is supported by internal signals, the perception of which is typically distorted in EWC. In this study, we sought to characterize in EWC: (i) risky decision-making by contrasting situations in which people process bodies or neutral objects and (ii) the relationship between interoceptive ability and risky decision-making. In a between-subject design, participants with AN restricting type, participants with class 2 OB, and two groups of matched healthy controls (HC) (total N = 160) were administered either the Balloon Analogue Risk Task (BART) or a modified version of it by using a body-related stimulus as a cue in the place of the balloon. Moreover, we collected a measure of interoceptive sensibility and a measure of interoceptive accuracy. Results showed that, when analysing the global population as a continuum based on the BMI, the risk propensity decreased as a function of increased BMI, only for the task involving a body-related stimulus. Moreover, while HC risk propensity toward a body-related stimulus correlated with interoceptive sensibility, such correlation was absent in participants with AN. Individuals with OB, on the opposite pole, showed mixed interaction between interoception and risky decision-making in both tasks. These findings add one more tile to understanding these complex pathologies in the EWC spectrum, opening up future differential rehabilitation scenarios.

Improving adult eating behaviours by manipulating time perspective: a systematic review and meta-analysis

There is a growing body of research on improving health behaviours through future thinking but that in improving eating behaviour remains unclear. Hence, we conducted a systematic review and meta-analysis on the effectiveness of time perspective manipulation in improving adult eating behaviours. Articles published from inception through 17 March 2022 were retrieved from eight databases (CINAHL, Embase, ProQuest, PsycINFO, PubMed, Scopus, The Cochrane library, and Web of Science). Meta-analysis was conducted using random effects models with effect sizes reported in Hedges' g. Sixteen experimental studies were included, representing 1,914 participants with mean ages ranging from 20.5 to 44.1 years old and mean baseline BMI of 22.0 kg/m2 to 37.2 kg/m2. The interventions included were episodic future thinking (EFT; n = 12), message framing (n = 2), and varying inter-meal intervals (IMI; n = 2) in improving food choices, food intake and portion size. Two studies reported significant interventional effectiveness for domain-specific EFT while all studies on message framing and IMI reported significant interventional effectiveness. Message framing seemed to be more effective when both temporal distance and valence frames were manipulated. However, the pooled effect sizes of all the interventions did not result in a significant interventional effect (n = 5; g = -0.49; 95% confidence interval (CI) = -1.44, 0.47; p = 0.23; I2=87.2%). More rigorous research is needed to ascertain the effectiveness of manipulating time perspective in improving eating behaviours before such interventions are more widely used.

Validation of the German long and short versions of the UPPS-P Impulsive Behavior Scale

OBJECTIVE

The UPPS-P Impulsive Behavior Scale is a widely used self-report measure of impulsivity, but there is currently no validated German version that includes the Positive Urgency scale.

METHODS

We combined existing German translations of UPPS scales and included the Positive Urgency dimension to validate the UPPS-P in a sample of 399 participants. In addition, we developed a revised short version of the UPPS-P (SUPPS-P) with 20 items and conducted a confirmatory factor analysis (CFA) to verify the structure in an independent validation sample with 349 participants. To determine evidence of convergent and discriminant validity, we used measures of impulsivity, depression, anxiety, stress, problematic alcohol and substance use.

RESULTS

CFA of the five factorial structure of the UPPS-P demonstrated acceptable fits and evidence of validity and reliability for the subscales. Psychometric characteristics of the SUPPS-P using the original item configuration were not satisfactory. As a result, we developed a revised German version of the SUPPS-P and confirmed the five-factor structure using a CFA in the validation sample. For the revised version, model fits and evidence of validity and internal consistencies were good. Associations with other constructs were as expected. For example, whereas Sensation Seeking was associated moderately with problematic alcohol use, lacking associations of Lack of Premeditation to internalizing symptoms showed evidence of discriminant validity.

DISCUSSION

The German translations of both UPPS-P and SUPPS-P are valid tools for measuring impulsive behaviors. They are well-suited for exploring the associations between different facets of impulsivity and psychopathological phenomena.

Scoping Review: Transdiagnostic Measurement of Impulsivity Domains in Youth Using the UPPS Impulsive Behavior Scales

OBJECTIVE

Impulsivity contributes to many clinically relevant behaviors impacting youth. A scoping review was conducted to characterize existing research using the Urgency, Premeditation (lack of), Perseverance (lack of), Sensation Seeking (UPPS) Impulsive Behavior Scales in youth populations, to review the psychometric and validity data of UPPS, and to summarize findings related to sex/gender and diagnostic populations of youth.

METHOD

PubMed, Embase, and PsycNET databases were searched from January 1, 2001 (original UPPS publication) through October 2, 2022, according to PRISMA extension for Scoping Reviews guidelines. Articles were reviewed for inclusion/exclusion by 2 authors. Original research articles in English using any UPPS version or subscale in persons aged ≤21 years were included.

RESULTS

Inclusion criteria were met by 45 articles, with low bias and moderate-to-high quality. Most were cross-sectional studies; studies investigated diverse community and clinical samples. The UPPS demonstrated consistent factor structure, good reliability, and good external validity with other measures of impulsive behaviors and conditions associated with impaired impulse control. Some studies observed differences in UPPS domain scores between sex/gender groups or differential patterns in relationships between UPPS domains and clinical variables. UPPS subscale scores often differed in youth with attention-deficit/hyperactivity disorder, conduct disorders, substance use, and excess weight/obesity compared with control youth. UPPS domains commonly had interactions with sex/gender, sociodemographic, and diagnosis-related variables.

CONCLUSION

The current literature suggests that the UPPS has utility in measuring distinct components of impulsivity in clinical and nonclinical populations of youth. Specificity in discriminating diagnostic groups and predicting risk currently remains uncertain. Further research is needed to integrate UPPS measures with experimental models and additional neurobiological methods and to assess longitudinal developmental trajectories.

PLAIN LANGUAGE SUMMARY

Impulsivity contributes to many clinically relevant behaviors and mental health disorders that impact youth. The Urgency, Premeditation, Perseverance, Sensation Seeking (UPPS) Impulsive Behavior Scale has been increasingly used in research to measure deficits in impulse control. In this scoping review the authors examined 45 studies that used versions of the UPPS to measure different domains of impulsivity in youth aged 21 years and younger. The authors found evidence in the literature for the validity and reliability of the UPPS and its variants in measuring impulsivity in youth. Certain patterns of UPPS subscale scores corresponded with clinical behaviors and diagnoses including attention-deficit/hyperactivity disorder (ADHD), conduct disorder, substance use, and excessive weight/obesity. Despite this, there remain gaps in the literature regarding the stability of UPPS measures over time and ability of the UPPS to predict clinical outcomes.

Effects of energy balance on cognitive performance, risk-taking, ambulatory vigilance and mood during simulated military sustained operations (SUSOPS)

Sustained operations (SUSOPS) require military personnel to conduct combat and training operations while experiencing physical and cognitive stress and limited sleep. These operations are often conducted in a state of negative energy balance and are associated with degraded cognitive performance and mood. Whether maintaining energy balance can mitigate these declines is unclear. This randomized crossover study assessed the effects of energy balance on cognitive performance, risk-taking propensity, ambulatory vigilance, and mood during a simulated 72-h SUSOPS.

METHODS

Ten male Soldiers (mean ± SE; 22.4 ± 1.7 y; body weight 87.3 ± 1.1 kg) completed two, 72-h simulated SUSOPS in random order, separated by 7 days of recovery. Each SUSOPS elicited ∼4500 kcal/d total energy expenditure and restricted sleep to 4 h/night. During SUSOPS, participants consumed either an energy-balanced or restricted diet that induced a 43 ± 3% energy deficit. A cognitive test battery was administered each morning and evening to assess: vigilance, working memory, grammatical reasoning, risk-taking propensity, and mood. Real-time ambulatory vigilance was assessed each morning, evening, and night via a wrist-worn monitoring device.

RESULTS

Participants exhibited heightened risk-taking propensity (p = 0.047) with lower self-reported self-control (p = 0.021) and fatigue (p = 0.013) during energy deficit compared to during energy balance. Vigilance accuracy (p < 0.001) and working memory (p = 0.040) performance decreased, and vigilance lapses increased (p < 0.001) during SUSOPS, but did not differ by diet. Percentage of correct responses to ambulatory vigilance stimuli varied during SUSOPS (p = 0.019) independent of diet, with generally poorer performance during the morning and night. Total mood disturbance (p = 0.001), fatigue (p < 0.001), tension (p = 0.003), and confusion (p = 0.036) increased whereas vigor decreased (p < 0.001) during SUSOPS, independent of diet.

CONCLUSION

Prolonged physical activity combined with sleep restriction is associated with impaired vigilance, memory, and mood state. Under such conditions, maintaining energy balance prevents increased risk-taking and improves self-control, but does not improve other aspects of cognitive function or mood. Given the small sample in the present study, replication in a larger cohort is warranted.

The outcome-representation learning model: impairments in decision-making in adolescents with excess weight

Impairments in decision-making have been suggested as a predisposing factor to obesity development. Individuals with excess weight display riskier decisions than normal weight people. Furthermore, adolescence is a period of life in which risky behavior may increase. We aimed to investigate decision making applying the Outcome-Representation-Learning (ORL) model to the Iowa Gambling Task (IGT) in adolescents with excess weight. Twenty-nine excess weight and twenty-eight normal weight adolescents, classified according to their age-adjusted body mass index (BMI) percentile, participated in the study. Decision-making was measured using the IGT. A Bayesian computational ORL model was applied to assess reward learning, punishment learning, forgetfulness, win perseverance and deck perseverance. The IGT net score was lower in excess weight than normal weight adolescents (β = 2.85; p < .027). Reward learning (95% HDI [0.011, 0.232]) was higher, while forgetfulness (95% HDI [− 0.711, − 0.181]) and deck perseverance (95% HDI [− 3.349, − 0.203]) were lower, in excess weight than normal weight adolescents. Excess weight adolescents seemed better at learning the most rewarding choices and showed a random strategy based on reward and novelty seeking. Consequently, excess weight adolescents made more disadvantageous selections, and performed worse in the IGT.

Influence of a Nutrigenetic Intervention on Self-Efficacy, Emotions, and Rewarding Behaviors in Unhealthy Eating among Mexicans: An Exploratory Pilot Study

The Genome-based Mexican (GENOMEX) diet is a strategy for preventing and managing obesity. Emotion and eating behavior in the context of a nutrigenetic intervention have not been thoroughly studied. We aimed to explore the influence of the GENOMEX diet on emotions, self-efficacy, and rewarding behaviors in unhealthy eating among subjects with risk factors for obesity-related chronic diseases. Twenty-eight subjects included in the six-month GENOMEX intervention answered questions regarding emotions that influence food consumption. Additionally, the Patient Health Questionnaire (PHQ-9) and the Reward-based eating drive scale (RED) were applied. In the study, minimal, mild, moderate, and severe depression were present in 46.4%, 39.3%, 10.7%, and 3.6%, respectively. RED did not change, but it correlated with a higher intake of fats (r² = 0.684, β = 2.066, p = 0.003). Mood influenced unhealthy eating in 71.7% of subjects, and 76.9% experienced binge episodes triggered by anxiety. Sugars were the most consumed foods during binge episodes (42.2%). Both low self-efficacy levels and binge episodes were associated with high consumption of unhealthy foods. After the intervention, 10.7% of subjects reported a high level of self-efficacy. In conclusion, a culturally acceptable and genetically compatible regional Mexican food diet reduced negative emotions and unhealthy eating while increasing self-efficacy.

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.

Salivary Alpha-Amylase Mediates the Increase in Hunger Levels in Adolescents with Excess Weight after Viewing Food Images

Background: Salivary alpha-amylase (sAA) initiates the digestion process in the mouth and its levels might influence feelings of hunger and the propensity toward obesity. This study aims to evaluate basal differences in sAA between adolescents with excess weight (EW) and normal weight (NW), and the associations between sAA levels and feelings of hunger after viewing food images. Methods: Adolescents (13-18 years old) classified as EW (n = 30) or NW (n = 30) participated in the study. Saliva samples were collected before the administration of a food-choice task. Hunger was evaluated before and after the food-choice task. Results: EW adolescents showed lower basal sAA levels than NW adolescents and a greater increase in hunger levels after viewing food images. In addition, sAA levels had a significant inverse relationship with the increase in hunger in EW adolescents, but not in NW adolescents. Finally, significant inverse associations between sAA, BMI, and body fat percentage were found. Conclusions: Levels of hunger and changes therein, after viewing food are dependent on sAA levels in EW adolescents. This finding indicates that sAA levels may be a mediator of feelings of hunger in individuals with overweight in the context of viewing food cues, suggesting the utility of the sAA enzyme as a marker of hunger and propensity toward obesity.