Binge eating, problem drinking, and pathological gambling: Linking behavior to shared traits and social learning

The relation between stress-induced dopamine release in the ventromedial prefrontal cortex, fronto-striatal functional connectivity, and negative urgency: A multimodal investigation using [18F]Fallypride PET, MRI and experience sampling

Negative urgency (NU), or the tendency to act rashly when stress of negative affect is high, could be the result of an insufficient control of the ventromedial prefrontal cortex (vmPFC) over the striatum, through an impaired dopamine (DA) transmission. Therefore, we investigated in vivo human stress-induced DA release in the vmPFC, its relation with fronto-striatal functional connectivity (FC), and NU in daily life. In total, 12 female healthy participants performed a simultaneous [18 F]fallypride PET and fMRI scan during which stress was induced. Regions displaying stress-induced DA release were identified and used to investigate stress-induced changes in fronto-striatal FC. Additionally, participants enrolled in an experience sampling study, reporting on daily life stress and rash actions over a 12-month-long period. Mixed models explored whether stress-induced DA release and FC moderated NU in daily life. Stress led to a lower FC between the vmPFC and dorsal striatum, but a higher FC between the vmPFC and contralateral ventral striatum. Participants with a higher FC between the vmPFC and dorsal striatum displayed more NU in daily life. A higher stress-induced DA release in the vmPFC was related to a higher stress-induced change in FC between the vmPFC and striatum. Participants with a higher DA release in the vmPFC displayed more NU in daily life. In conclusion, stress could differentially impact fronto-striatal FC whereby the connectivity with the dorsal striatum is especially important for NU in daily life. This could be mediated by a higher, but not a lower, stress-induced DA release in the vmPFC.

Evaluating the predictions of an interoceptive inference model of bulimia nervosa

OBJECTIVE

Bulimia nervosa (BN) is associated with loss-of-control (LOC) eating episodes that frequently occur in response to negative emotions. According to recent neurocomputational models, this link could be explained by a failure to accurately update beliefs about the body in states of high arousal. Specifically, these interoceptive inference models suggest that under-relying on signals from one's body about sensory experience ("low sensory precision") and/or over-relying on previously held beliefs ("excessively precise priors") lead to inaccurate perception and maladaptive behaviors. We conducted an initial test of these core predictions of the interoceptive inference model in BN using self-report measures.

METHODS

We compared women with BN (n = 30) and age-, BMI-, and full-scale IQ-matched controls (n = 31) on trust in sensory information from the body and two types of beliefs about what can be done to regulate high negative affect. Within the BN group, we tested interrelations among these measures and explored their associations with LOC eating frequency.

RESULTS

Compared with healthy controls, the BN group reported lower levels of trust in sensory information and stronger beliefs that once upset, there is little one can do, apart from eating, to self-regulate. These beliefs were associated with each other and with lower body trust. Beliefs about the uncontrollability of emotion were associated with more frequent subjective binge-eating episodes.

CONCLUSIONS

Findings provide initial support for the core predictions of an interoceptive inference account of BN: low trust in sensory information ("sensory precision") may promote an overreliance on maladaptive "prior beliefs" about the effects of eating on negative emotions, ultimately interfering with accurate updating of beliefs about other strategies that could regulate emotions and maintain LOC eating. Low body trust, strong expectations about emotions, and their neurocomputational underpinnings could be promising combined treatment targets for BN.

Impulsivity and compulsivity in gambling disorder and bulimic spectrum eating disorders: Analysis of neuropsychological profiles and sex differences

BACKGROUND

Gambling disorder (GD) and bulimic spectrum eating disorders (BSDs) not only share numerous psychopathological, neurobiological, and comorbidity features but also are distinguished by the presence of inappropriate behaviours related to impulsivity and compulsivity. This study aimed to emphasise the differences and similarities in the main impulsivity and compulsivity features between GD and BSD patients, and to analyse the potential influence of sex in these domains.

METHODS

Using self-reported and neurocognitive measures, we assessed different impulsive-compulsive components in a sample of 218 female and male patients (59 with BSD and 159 with GD) and 150 healthy controls.

RESULTS

We observed that GD and BSDs exhibited elevated levels of impulsivity and compulsivity in all the dimensions compared to healthy controls. Moreover, these disorders showed differences in several personality traits, such as high novelty seeking in GD, and low persistence and high harm avoidance in BSDs. In addition, patients with BSDs also displayed a trend towards greater impulsive choice than GD patients. Regarding sex effects, GD women presented higher overall impulsivity and compulsivity than GD men. Nevertheless, no sex differences were found in BSDs.

CONCLUSIONS

Clinical interventions should consider these deficits to enhance their effectiveness, including adjunctive treatment to target these difficulties. Our findings also provide support to the relevance of sex in GD, which should also be considered in clinical interventions.

Ghrelin and impulsivity relationship in alcohol-dependent patients and healthy individuals

AIMS

Abundant research indicates that ghrelin hormone levels are associated with alcohol use and addiction. One of the mediators of this association may be impulsivity, which is one of the common traits observed in alcohol addiction and some eating disorders. This study evaluated participants with alcohol dependency and healthy volunteers to determine whether trait impulsivity and ghrelin levels are associated.

METHODS

This study analyzed trait impulsivity scores and fasting serum ghrelin levels of 44 males with alcohol dependency and 48 healthy male participants. The Barratt Impulsiveness Scale and the UPPS Impulsive Behaviour Scale (UPPS) were used to measure trait impulsivity levels. Penn Alcohol Craving Scale and Yale Brown Obsessive Compulsive Drinking Scale for heavy drinking were used to assess craving at the baseline and after the detoxification period.

RESULTS

Alcohol-dependent patients' fasting ghrelin levels were significantly higher than that of healthy participants. Ghrelin plasma levels were positively correlated with UPPS total impulsivity scores and sensation-seeking among healthy individuals. In alcohol-dependent participants, there was a positive correlation between UPPS urgency scores obtained at the baseline and fasting ghrelin levels before and after the detoxification period.

CONCLUSIONS

Ghrelin-impulsivity relationship could be observed in certain dimensions of impulsivity in both alcohol-dependent and healthy individuals and even independent of the effect of alcohol. Although the associated impulsivity dimensions differ in different groups, the results are parallel to other studies in terms of demonstrating the relationship between ghrelin and impulsivity.

Measurement and Functional Equivalence of a Reduced Version of the UPPS Impulsivity Scale Among Hispanic, Non-Hispanic Black, and Non-Hispanic White Adolescents

The current study aimed to assess the measurement equivalence and functional equivalence of the UPPS (Urgency, Premeditation, Perseverance, Sensation Seeking) Impulsivity Scale among three ethnoracial adolescent samples in the U.S. seventh-grade students who self-identified as Hispanic (n = 472), non-Hispanic Black (n = 89), or non-Hispanic White (n = 90), and completed an English-language version of the Child version of the UPPS, which was shortened and modified to include positive urgency items. Through a series of confirmatory factor analyses, the UPPS demonstrated configural, metric, and partial threshold invariance. Fisher's r-to-z transformations were used to assess the functional equivalence of the UPPS against well-validated measures of self-regulation and mental health commonly associated with impulsivity. We found some group differences in the magnitude of associations. Yet, overall, this study provides evidence that the UPPS can be used to measure distinct factors of impulsivity among Hispanic, non-Hispanic Black, and non-Hispanic White adolescents.

Neurodevelopmental Model Explaining Associations between Sex Hormones, Personality, and Eating Pathology

Clinical scientists have been investigating the relationships between sex hormones, personality, and eating disorders for decades. However, there is a lack of direct research that addresses whether personality mediates or moderates the relationships between sex hormones and eating pathology. Moreover, the neural mechanisms that underlie the interactive associations between these variables remain unclear. This review aims to summarize the associations between these constructs, describe a neural mechanism mediating these relationships, and offer clinical strategies for the early identification and intervention of eating disorders. The gathered evidence shows that aggressiveness, impulsivity, and obsessive-compulsiveness may mediate or moderate the relationships between sex hormones and eating pathology, but only among females. Furthermore, sex hormone receptor density in the mesocorticolimbic dopamine pathway may explain the neural mechanism of these associations. Future research should use more comprehensive personality measurements and assess the mediation and moderation effects of temperament while taking the hormone levels of women across menstrual cycles into account. Additionally, electroencephalography and functional magnetic resonance imaging should be implemented to directly assess brain activity and corroborate these findings.

Latent classes of eating disorders and addictions by sex: Implication of alexithymia and stressful life events in youths

Introduction

Eating disorders (EDs) and behavioural addictions show common psychological vulnerability factors such as alexithymia and stressful life events (SLE). This study aims, firstly, to explore the prevalence and latent profiles of participants based on their risk of suffering EDs, gambling disorder (GD), alcohol and/or drug abuse, and compulsive buying (CB) by sex. Secondly, it aimed to test whether alexithymia and having experienced SLE are associated with group membership.

Methods

The sample was predominantly drawn from university students and social networks. It was composed of 352 young adults between 18 and 35 years old, of whom 77.8% were women and 22.2% men.

Results

The results showed that the most prevalent disorders of the sample were alcohol, EDs, CB, drugs and GD, respectively. Moreover, latent class analyses were conducted based on the risk of suffering EDs or addictions by sex. Three main profiles were found: 'Men with addictions', 'Healthy women' and 'Women with EDs'. Finally, differences in SLE and alexithymia levels were tested by latent classes. "Men with addictions" and "Women with EDs" had higher scores on alexithymia and SLE than the group of "Healthy women". However, the group of "Women with EDs" (class 3) reported significantly higher levels of SLE and alexithymia than the other two groups.

Discussion and conclusion

In conclusion, we discuss the possibility that some vulnerability factors operate generally and transdiagnostically in EDs and addictive disorders. The identification of clinical phenotypes could complement and deepen prediction, prevention and treatment research in clinical settings. The need to take sex and gender differences into account is reinforced.

Greater negative affect reduction expectancies moderate the interactive relationship between emotion regulation difficulties and distress tolerance in predicting loss-of-control eating

OBJECTIVES

Loss-of-control eating (LOCE) is often conceptualized as a negative reinforcement mechanism. However, LOCE does not consistently reduce negative affect (NA). One explanation for continued LOCE, despite a lack of NA reduction, may be expectations of NA reduction. Emotion regulation difficulties and low distress tolerance often predict LOCE, but have not been examined in the context of NA reduction expectancies.

DESIGN

This study examined the main and interactive relationships between emotion regulation difficulties, distress tolerance and NA reduction expectancies on LOCE in US adults (n = 3331).

METHOD

This study consisted of a battery of surveys administered to a national sample of US adults.

RESULTS

Results indicate NA reduction expectancies are robust, eclipsing the predictive effects of other emotion regulation variables. Distress tolerance was only able to attenuate the relationship between emotion regulation difficulties and LOCE when NA reduction expectancies were low.

CONCLUSIONS

These findings identify NA reduction expectancies as having a strong relationship with LOCE, such that the protective factor of distress tolerance is only relevant when such expectancies are low. Clinical implications suggest that targeting NA reduction expectancies in eating interventions that bolster emotion regulation difficulties and distress tolerance may improve the effectiveness of said interventions. Additionally, stand-alone expectancy interventions should be assessed for the purpose of LOCE reduction. Directions for future research are discussed.

The role of eating expectancies and eating motives in the association between mood and loss-of-control eating: A national sample daily diary study

Loss-of-control eating (LOCE, the subjective inability to refrain from eating or cease eating), is highly mood-driven. Mood-related eating motives and eating expectancies have been identified as contributors to binge eating. However, little is known about how these factors relate to LOCE, much less their relationship with daily-level LOCE. This study assessed the impact of trait eating expectancies and daily eating motives on the relationship between daily affective states and LOCE. United States adults (n = 109) reporting recent LOCE participated in a ten-day diary study, completing two surveys per day regarding eating behaviors, mood, and motives. Data were analyzed at the within- and between-subject levels utilizing a Bayesian approach to examine pathways from mood to LOCE, mediated by eating motives and accounting for a moderating impact of baseline eating expectancies on the path leg between mood and motives. Negative mood was associated with LOCE at both the within- and between-subjects level by way of coping motives, and directly at the within-subjects level. Negative affect (NA) reduction expectancies did not moderate the indirect pathway. Positive mood was only associated with LOCE at the within-subjects level, via pleasure motives. This relationship was potentiated via reward expectancies. Therefore, although negative mood appears be a robust predictor of LOCE regardless of trait NA reduction expectancies, positive mood appears to have a specific set of conditions under which individuals are at increased likelihood of LOCE at the within-subjects level. These findings suggest that eating expectancies and motives for eating may be meaningful targets in LOCE interventions.

Eating disorders and the nine symptoms of borderline personality disorder: A systematic review and series of meta-analyses

OBJECTIVE

Eating disorders and borderline personality disorder have high rates of comorbidity. However, the extent to which individual BPD symptoms are elevated in patients with EDs is largely unknown. Meta-analyses examined: (1) which of the nine BPD symptoms are especially elevated in individuals with versus without EDs, (2) whether particular ED subtypes have elevated levels of certain BPD symptoms, and (3) which BPD symptoms remain unstudied/understudied in relation to EDs.

METHODS

We performed nine separate meta-analyses (one for each BPD symptom) to compare levels of symptoms in patients with EDs versus healthy controls. A total of 122 studies (range = 4-34 studies across symptoms) were included.

RESULTS

Affective instability was the BPD symptom most elevated, while anger was the BPD symptom least elevated, in patients with EDs compared to controls. When comparing effect sizes across ED subtypes, anorexia nervosa binge-eating/purging subtype had the largest effect sizes for the greatest number of BPD symptoms, while effect sizes for AN restrictive subtype were not significantly larger than those of other EDs for any BPD symptom. The least studied BPD symptoms were identity disturbance and interpersonal difficulties.

DISCUSSION

These meta-analyses suggest that certain symptoms of BPD play a more prominent role in the comorbidity between BPD and EDs than others. Targeting affective instability when treating cases of comorbid ED and BPD may be especially likely to ameliorate the negative outcomes related to this comorbidity. Future research should further investigate identity disturbance and interpersonal difficulties in the context of EDs.

PUBLIC SIGNIFICANCE

Having an eating disorder and borderline personality disorder is a common comorbidity associated with a severe clinical presentation. BPD is characterized by nine distinct symptoms. This research examined levels of individual BPD symptoms in patients with versus without EDs. Findings can guide researchers and clinicians towards studying and treating symptoms that may be most relevant for BPD-ED comorbidity and in turn, improve outcomes for these patients.

The interaction between affective lability and eating expectancies predicts binge eating

Both affective lability and eating expectancies have been found to predict binge eating. There is the additional possibility that the joint effect of affective lability and eating expectancies incurs further risk: perhaps expectancies for affective relief from eating operate more strongly in those experiencing frequent, rapid shifts in emotion. In the current study, we tested whether such a joint effect predicts binge eating prospectively in college students. We assessed affective lability, eating expectancies, and binge eating in 358 college students at two time points during the first year of college (e.g., December and April). The interaction of affective lability and eating expectancies in December predicted binge eating 4 months later in April. The influence of eating expectancies on binge eating was stronger at higher levels of affective lability. Findings offer support to the hypothesis that risk factors may transact to further elevate risk for eating disorder behaviors.Clinical implicationsThe interaction of affective lability and eating expectancies predicts binge eatingRisk factors may interact to further increase binge eatingIdentification of co-occurring risk factors may have vital treatment implications.

Eating expectancies and hedonic hunger among individuals with bulimia-spectrum eating disorders who plan binge-eating episodes

OBJECTIVE

Binge planning (BP; i.e., preparatory thoughts and actions to facilitate future binge-eating episodes) is hypothesized to distract individuals from negative affect and increase the salience of food. Thus, individuals who engage in BP may report greater positive eating expectancies (i.e., beliefs about the outcomes of eating) and hedonic hunger (i.e., desire to eat for pleasure), as BP may increase the likelihood of obtaining these expected outcomes; but empirical tests of this possibility are needed.

METHOD

Prior to starting treatment, adults (N = 86) with bulimia-spectrum eating disorders were assessed for engagement in BP and self-reported on eating expectancies and hedonic hunger.

RESULTS

Twenty-nine participants (33.7%) reported planning at least one binge-eating episode in the previous 28 days. Compared to individuals who did not report BP, individuals who reported BP had greater expectancies that eating would alleviate negative affect (t = -2.54, p = .013) and boredom (U = 503.50, p = .006). Groups did not differ on levels of hedonic hunger (t = -1.68, p = .096).

DISCUSSION

These findings suggest that BP status is linked to expectancies that eating will reduce negative affect. However, more data are needed to determine the temporal relationships among eating expectancies, hedonic hunger and BP.

TRIAL REGISTRATION NUMBERS

NCT02716831, NCT03673540.

Latent profiles of impulsivity facets and associations with drinking behaviors

BACKGROUND

Impulsivity is positively associated with alcohol use. However, scant research has used person-centered approaches to examine how patterns of impulsivity facets may be associated with alcohol-related outcomes. Consequently, the present study sought to (1) identify latent groups of individuals who share similarities based on the five facets of impulsivity assessed using the UPPS-P scale (positive urgency, negative urgency, premeditation, perseverance, and sensation seeking) and (2) examine differences between latent profiles on alcohol use (i.e., typical alcohol quantity, typical alcohol frequency, binge frequency), alcohol consequences, and drinking motivations.

METHODS

Participants were 360 (M age = 21.83; 78.9 % female; 49.4 % racial/ethnic minority) college students who reported weekly drinking over the prior 30 days. They completed questionnaires of impulsivity, alcohol use behaviors, alcohol consequences, and drinking motivations. Latent profile analysis was used to identify classes based on the five UPPS-P facets as indicators.

RESULTS

Results revealed that three classes best fit the data: Highest UPPS-P (14.4 %); Moderate UPPS-P (56.9 %); and Lowest UPPS-P (28.6 %). Profiles did not vary on drinking behaviors (quantity, frequency, or binge frequency), but significant differences were observed on alcohol consequences and drinking motivations, specifically coping and conformity motives.

CONCLUSIONS

Our data demonstrated that UPPS-P facets tend to cluster together, and patterns may pose risk for consequences and negative motives for drinking. The current study contributed to the conceptualization of impulsivity by identifying specific impulsivity typologies that may be used to target individuals at elevated risk for alcohol consequences.

Executive functions in binge spectrum eating disorders with comorbid compulsive buying

OBJECTIVE

The aims were to explore if bulimic spectrum disorders (BSD) patients, who also present comorbid compulsive buying (CB), could represent a specific subtype considering its neuropsychological performance; to present a descriptive analysis of different clinical features; and to explore how these variables could influence treatment outcome. It was hypothesised that the comorbid group will present worse neuropsychological performance that will lead to a worse treatment outcome.

METHOD

The study has a longitudinal design. Women (N = 75) diagnosed with BSD, BSD + CB and Healthy Controls (HC); completed an evaluation of: cognitive flexibility, decision making, eating disorder (ED) symptomatology, psychopathological state and personality traits.

RESULTS

BSD + CB was the group with the most severe clinical profile, worst treatment outcome and higher neuropsychological impairment, than other groups. Path-analysis evidenced that deficits in decision making were associated with bad treatment outcome, while deficits in flexibility with the presence of the comorbidity. Self-directedness and novelty seeking were associated with the neuropsychological performance and the comorbidity.

CONCLUSION

BSD + CB exhibit a worse clinical and neuropsychological profile that seems to be related with the treatment outcome, which should be taken into account for the establishment of specific treatment approaches.

Psychopathy and Occurrence of Gambling Problems: The Role of Gambling Protective Strategies and Urgency

BACKGROUND

Psychopathy has been an increasing area of clinical and personality research and is associated with numerous problematic outcomes, including pathological gambling, though this area of research is limited. The most common conceptualization of psychopathy is a two-factor model of primary and secondary psychopathy, with primary psychopathy comprising more interpersonal traits and secondary psychopathy encompassing more antisocial behaviors. Previous research has linked psychopathy to greater urgency and lower utilization of harm reduction strategies.

OBJECTIVES

The current study examines the relationship between primary psychopathy, secondary psychopathy, and problematic gambling, as well as the possible mechanisms of these relationships.

METHOD

College student gamblers (n = 308) completed surveys on psychopathy, impulsivity, protective behavioral strategies regarding gambling, and possible gambling problems.

RESULTS

Primary psychopathy was inversely related to gambling protective behavioral strategies (PBS) and secondary psychopathy was positively associated with higher levels of urgency. Secondary psychopathy, via urgency, was a strong predictor of whether an individual will experience gambling problems, while primary psychopathy via PBS better predicts the number of gambling problems one experiences.

CONCLUSION

This study extends an overall under-researched area of gambling and personality and highlights the importance of delineating different factors of psychopathy regarding problematic gambling outcomes.

Examining the differential effects of latent impulsivity factors on substance use outcomes in African American men

African Americans have elevated substance use-related problems during adulthood despite initiating use later than individuals of other racial/ethnic backgrounds. The present study first validated the structure of the UPPS-P Impulsive Behavior Scale and then examined impulsivity as a prospective risk factor for future alcohol, cannabis, and tobacco use, as well as generalized substance problems, in African American men. Data were drawn from the African-American Men's Project, which recruited participants (N_WAVE-1 = 504; Mean age_WAVE-1 = 20.7; N_WAVE-3 = 379; Mean age_WAVE-3 = 23.6) from rural counties of Georgia. Participants responded to an adapted version of the UPPS-P at Wave 1. Confirmatory factor analyses determined that a 5-factor model of impulsivity and a 3-factor hierarchical model of impulsivity described the data equally well, in comparison to 1-factor, 4-factor, or bifactor models. This supports that the structure of the abbreviated UPPS-P in African Americans is likely consistent with observations in White, Hispanic/Latino, and admixed samples. Notably, all second-order factors of the UPPS-P are not alike in predicting substance use outcomes when examined jointly in African American men. Only Deficits in Conscientiousness, which is a second-order factor comprised of Lack of Premeditation and Lack of Perseverance, affected whether individuals met any criteria for future substance use problems. Our findings provide novel insight into the relationship between impulsivity and substance involvement during emerging adulthood in African American men.

Emotion dysregulation moderates the relationship between alcohol use and eating pathology among heavy-drinking college men

OBJECTIVES

There is limited research examining the relationship between alcohol use and eating pathology in men or factors that may moderate this association. The current study investigated the relationship between alcohol use and eating pathology, and examined emotion dysregulation as a moderator of this association, among heavy-drinking college men.

METHOD

Men mandated to receive an alcohol intervention (N = 88; average age = 19 years) completed questionnaires related to alcohol use, emotion dysregulation, and eating pathology.

RESULTS

Results demonstrated positive relationships between alcohol use and some eating pathology, and a significant interaction between alcohol use and emotion dysregulation. However, results were contrary to hypotheses, such that there was a positive relationship between alcohol use and eating pathology at low levels of emotion dysregulation.

CONCLUSION

Future studies should continue to examine the overall presentation of eating pathology in men and investigate factors that may impact the relationship between alcohol use and eating pathology.

Association between alcohol consumption status and obesity-related comorbidities in men: data from the 2016 Korean community health survey

Background

This study was performed to investigate the association between the amount of alcohol consumption or binge drinking and obesity-related comorbidities in Korean men.

Methods

A total of 103,048 men aged 19 years or older were investigated in the 2016 Korean Community Health Survey. The participants were divided into five groups according to the standard number of alcoholic drinks consumed per week.

Results

Of the total participants, 20.7% were in the high alcohol consumption group, consuming more than 28 drinks per week. After adjustment for clinical factors, high alcohol consumption was significantly associated with higher odds ratios (ORs) of obesity (OR, 1.449; 95% confidence interval [CI], 1.412 to 1.591; P < 0.0001), hypertension (OR, 1.76; 95% CI, 1.636 to 1.894; P < 0.0001), and dyslipidemia (OR, 1.356; 95% CI, 1.247 to 1.474; P < 0.0001). In contrast, mild to moderate alcohol consumption was associated with a lower risk of diabetes (OR, 0.799; 95% CI, 0.726 to 0.88; P = 0.0015) and high alcohol consumption was not associated with a higher risk of diabetes (OR, 0.945; 95% CI, 0.86 to 1.039; P = 0.0662). Among drinkers, except for social drinkers, binge drinking was significantly associated with higher risks of obesity, hypertension, diabetes, and dyslipidemia.

Conclusions

High alcohol consumption was associated with higher risks of obesity, hypertension, and dyslipidemia in Korean men. In contrast, high consumption was not associated with a higher risk of diabetes. In particular, binge drinkers were associated with higher risks of obesity, hypertension, diabetes, and dyslipidemia compared to non-binge drinkers.

The role of family conflict in mediating impulsivity to early substance exposure among preteens

OBJECTIVES

Preadolescence substance exposure, which increases the risk of regular substance use, has been a public health concern. Although studies found that impulsivity is a predisposing factor of early substance exposure, the pathways through which impulsivity is associated with early substance exposure remain unclear. This study examined how family conflict mediates this association among U.S. preteens as family environment plays an essential role in pre-adolescent development.

METHODS

Respondents (N = 11,800, 9-10 years old) from the Adolescent Brain Cognitive Development (ABCD) Study Release 2.01 (July 2019) were included in this study. Generalized structural equation modeling was performed to investigate the mediation effects of family conflict on the associations between childhood impulsivity and early exposure to alcohol and tobacco use, controlling for covariates based on the Problem Behavior Theory.

RESULTS

Pre-adolescents with high impulsivity levels (≥90^th percentile) were more likely to report early alcohol and tobacco exposure (total effect: ORs = 1.49 and 1.70, respectively), where 4.13% and 12.41% of the associations, respectively, were meditated by family conflict (indirect effect: ORs = 1.02 and 1.07; Sobel test ps = 0.022 and 0.005, respectively).

CONCLUSIONS

Family conflict mediates the associations between childhood impulsivity and early substance exposure among preteens, with higher impulsivity leading to more severe family conflicts that are, in turn, associated with a higher likelihood of early substance exposure. To prevent preteens with high impulsivity level from early use of substances, interventions may focus on reducing family conflicts such as parenting counseling that guides parents to strengthen conflict-resolution skills and create a stable home environment for preteens.

Multidimensional elements of impulsivity as shared and unique risk factors for food addiction and alcohol misuse

Food addiction (FA) and alcohol misuse tend to co-occur, which suggests shared factors in the etiology and persistence of these health behaviors. One shared factor that has been linked to both is impulsivity, a multidimensional construct reflecting multiple facets of self-regulatory capacity. However, co-occurrence also raises issues of possible confounding if both domains are not considered concurrently, and the intersection between FA, alcohol misuse, and impulsivity has not been well characterized empirically. Therefore, the current study examined the intersection of FA, alcohol consequences, and multiple indicators of impulsivity. Participants were emerging adults reporting regular heavy episodic drinking recruited from Hamilton, Ontario (N = 730; ages 19.5-23). Participants completed measures of FA, alcohol problems, impulsive personality traits (i.e., Barratt Impulsiveness Scales, UPPS-P Impulsive Behavior Scales), impulsive choice (i.e., delay discounting), impulsive action (i.e., Go/NoGo task). Findings revealed a significant association between FA and alcohol-related consequences and both shared similar associations with specific impulsive personality traits (Positive and Negative Urgency, Lack of Premeditation, Motor and Attentional Impulsivity). However, alcohol-related consequences were uniquely associated with other impulsive personality traits (Lack of Perseverance, Sensation Seeking, Non-planning impulsivity) and impulsive choice, and FA was uniquely associated with impulsive action. Beyond alcohol-related consequences, FA was associated with additional variance in measures of impulsive personality traits (Positive and Negative Urgency, Lack of Premeditation, Motor Impulsivity, and Attentional Impulsivity) and impulsive action, but not impulsive choice. Overall, the current study reveals several common self-regulatory processes associated with both adverse drinking consequences and FA, and that the risk of inadvertent confounding appears to be limited.

The associative underpinnings of negative urgency and its role in problematic gambling behavior

BACKGROUND

Negative urgency -the tendency to lose control under the influence of strong negative emotions- has been proposed to be a sign of malfunctioning emotion regulation mechanisms, and to contribute to severity and complications of gambling disorder and other externalizing behaviors.

AIMS AND METHOD

This study is aimed at (1) testing whether negative urgency is linked to resistance to extinction in an emotional associative learning task in a sample of 70 participants, 65 of whom were active gamblers (with emotional pictures as unconditioned stimuli, and color patches as conditioned stimuli [CS]); and (b) exploring the link between these two variables (negative urgency and resistance to emotional extinction) and clinical manifestations of gambling (severity and craving). Mixed-effects generalized models were used to analyze trial-by-trial predictive responses during acquisition and extinction for erotic, disgusting, and gambling-related pictures.

RESULTS AND CONCLUSIONS

Acquisition of CS-elicited responses remained unaffected by negative urgency, whereas extinction was hampered in individuals with high negative urgency, especially for CSs associated with erotic and gambling-related pictures. Moreover, negative urgency predicted higher craving scores, and these predicted more severe gambling-related symptoms. This finding resonates with the well-known involvement of emotion regulation processes in craving control. However, extinction was not independently related to craving. This lacking effect suggests that negative urgency is a broad construct, and although some of its components are directly related to faulty extinction (and generalized emotion dysregulation), such components are not the same negative urgency shares with difficulties of craving control.

A Two-level Moderated Latent Variable Model with Single Level Data

With single-level data, Yuan, Cheng and Maxwell developed a two-level regression model for more accurate moderation analysis. This article extends the two-level regression model to a two-level moderated latent variable (2MLV) model, and uses a Bayesian approach to estimate and test the moderation effects. Monte Carlo results indicate that: 1) the new method yields more accurate estimate of the interaction effect than those via the product-indicator (PI) approach and latent variable interaction (LVI) with single-level model, both are also estimated via Bayesian method; 2) the coverage rates of the credibility interval following the 2MLV model are closer to the nominal 95% than those following the other methods; 3) the test for the existence of the moderation effect is more reliable in controlling Type I errors than both PI and LVI, especially under heteroscedasticity conditions. Moreover, a more interpretable measure of effect size is developed based on the 2MLV model, which directly answers the question as to what extent a moderator can account for the change of the coefficient between the predictor and the outcome variable. A real data example illustrates the application of the new method.

Nonmedical Interventions for Schizophrenia: A Review of Diet, Exercise, and Social Roles

Schizophrenia is a major mental illness with a disease course that is influenced by lifestyle. The risk-benefit ratio for alternative interventions is more favorable than for antipsychotics in long-term treatment. Dietary interventions may target autoimmune features, vitamin or mineral deficiencies, abnormal lipid metabolism, gluten sensitivity, or others. Examples of interventions involving diet, physical activity, or physical processes or social interventions including talk therapy exist in the literature. Notwithstanding, the general utility of these types of interventions remains inconclusive, awaiting long-term randomized trials. A perspective that separates the cause of the disease from its symptoms may be helpful in treatment planning and is warranted to distinguish between short-term and long-term recovery goals.

A characterization of binge planning behavior in individuals with binge-spectrum eating disorders

OBJECTIVE

Although binge eating is associated with impulsivity, clinical reports suggest that some individuals with bulimia nervosa (BN) and binge eating disorder (BED) plan binge episodes in advance. This study is the first to examine: (1) the frequency of binge planning (BP; defined as both advanced knowledge that a binge episode will occur and taking steps to facilitate the binge episode); (2) associations of BP with ED severity, and (3) whether BP serves a negative reinforcement function.

METHOD

Patients with BN- and BED-spectrum eating disorders (EDs; n = 111) were administered semi-structured interview questions regarding BP.

RESULTS

Results indicate that a substantial minority of patients (27.8%) engage in BP. BP was significantly more common in BN versus BED-spectrum EDs (38.3% versus 20.6%, p = 0.04) and in those who did versus did not endorse self-induced vomiting (50.0% versus 21.3%, p < 0.01). Frequency of BP was positively associated with overall ED psychopathology (r = 0.19, p < 0.05). Exploratory analyses indicated that approximately two-thirds (67.7%) reported that BP served to distract from unpleasant experiences.

DISCUSSION

BP is present for a significant subset of patients and may play a critical role in the reinforcement cycles of binge eating. Future research should further elucidate the function of BP to inform treatment development.

Impulsivity, Emotional Intelligence, and Alcohol Consumption in Young People: A Mediation Analysis

Alcohol consumption in young people is a public health problem. Due to the harmful consequences and the large population using alcoholic substances, it would be important to determine the biological, psychological, and social factors associated with alcohol use and abuse. The main object of this study is to explore which components of impulsivity, according to the main theoretical models, have predictive power regarding alcohol consumption in young people. A secondary objective is to determine if emotional intelligence has a mediating role between the components of impulsivity and alcohol consumption, and thus specifically contribute to the knowledge about the mediation processes between those variables that are involved in the initiation and maintenance of alcohol consumption. For this purpose, 384 participants were recruited (83.1% females, n = 319), with mean age of 20.46 years (SD = 1.90; range 18-25). All participants were alcohol consumers at the beginning of the study. Data collection was conducted via online survey; impulsivity was evaluated by several questionnaires (Sensation Seeking Scale Form V, Barratt Impulsivity Scales 11, and Sensitivity to Punishment and Sensitivity to Reward), and emotional intelligence was evaluated by the Trait Meta-Mood Scale. The results reveal that the dimension of disinhibition (a dimension of the sensation search scale) significantly has the highest predictive value on alcohol consumption. Moreover, our data show that the total effect and direct effect of disinhibition on frequency of alcohol consumption were both significant. The mediating role of emotional intelligence in this process was also significant. These findings show which variables should be considered to prevent alcohol consumption in young people.

Demographic and psychiatric correlates of compulsive sexual behaviors in gambling disorder

BACKGROUND AND AIMS

Gambling disorder (GD) and compulsive sexual behavior (CSB) may commonly co-occur. Yet, the psychiatric correlates of these co-occurring disorders are an untapped area of empirical scrutiny, limiting our understanding of appropriate treatment modalities for this dual-diagnosed population. This study examined the demographic and clinical correlates of CSB in a sample of treatment-seeking individuals with GD (N = 368) in São Paulo, Brazil.

METHODS

Psychiatrists and psychologists conducted semi-structured clinical interviews to identify rates of CSB and other comorbid psychiatric disorders. The Shorter PROMIS Questionnaire was administered to assess additional addictive behaviors. The TCI and BIS-11 were used to assess facets of personality. Demographic and gambling variables were also assessed.

RESULTS

Of the total sample, 24 (6.5%) met diagnostic criteria for comorbid CSB (GD + CSB). Compared to those without compulsive sexual behaviors (GD - CSB), individuals with GD + CSB were more likely to be younger and male. No differences in gambling involvement emerged. Individuals with GD + CSB tended to have higher rates of psychiatric disorders (depression, post-traumatic stress disorder, and bulimia nervosa) and engage in more addictive behaviors (problematic alcohol use, drug use, and exercise) compared to GD - CSB. Those with GD + CSB evidenced less self-directedness, cooperativeness, self-transcendence, and greater motor impulsivity. Logistic regression showed that the predictors of GD + CSB, which remained in the final model, were being male, a diagnosis of bulimia, greater gambling severity, and less self-transcendence.

DISCUSSION AND CONCLUSION

Given those with GD + CSB evidence greater psychopathology, greater attention should be allocated to this often under studied comorbid condition to ensure adequate treatment opportunities.

Understanding profiles of student binge drinking and eating: The importance of motives

Binge drinking and binge eating occur frequently in undergraduates; however, the mechanism driving their co-occurrence is not well-understood. Several theories support the role of motives in driving drinking and eating behavior, especially motivations related to affect regulation (i.e., enhancement/pleasure and coping). This study used a person-centered approach to identify classes of students based on eating and drinking motives and past-month binge behavior and examined class differences in psychopathology, emotion regulation, and impulsivity. Undergraduates (N = 776) completed a drinking timeline follow-back and surveys assessing motives, binge eating, psychopathology, emotion regulation, impulsivity, and quality of life. Mixture modeling was used to group students based on presence/absence of past-month binge eating, binge drinking, and motives for eating and drinking. The analysis resulted in 4 classes: Binge Drinking (with relatively high social and enhancement drinking motives), Binge Eating (with overall high eating motives), Both Bingeing (with high drinking motives, especially coping, and high eating motives), and Low Bingeing (with low motives for both behaviors). ANOVA and post-hoc analyses suggested that the Binge Eating and Both Bingeing groups were most impaired, while the Binge Drinking class rarely differed from the Low Bingeing group across measures of psychological distress. Notably, classes with high eating/drinking motives displayed significant impairment despite not all class members endorsing binge behavior. Findings suggest that binge drinking in addition to binge eating may not imply more psychological impairment and support the importance of assessing motives for eating/drinking among undergraduates and potentially trying to challenge these motives through early intervention.

Revisiting the Role of Impulsivity and Compulsivity in Problematic Sexual Behaviors

Impulsivity and compulsivity are transdiagnostic features associated with clinically relevant aspects of psychiatric disorders, including addictions. However, little research has investigated how impulsivity and compulsivity relate to hypersexuality and problematic pornography use. Thus, the aims of the present study were to investigate (a) self-reported impulsivity and compulsivity with respect to hypersexuality and problematic pornography use and (b) the similarities and possible differences between hypersexuality and problematic pornography use in these domains. Utilizing structural equation modeling (SEM) in a large community sample (N = 13,778 participants; female = 4,151, 30.1%), results indicated that impulsivity (β = .28, β = .26) and compulsivity (β = .23, β = .14) were weakly related to problematic pornography use among men and women, respectively. Impulsivity had a stronger relationship (β = .41, β = .42) with hypersexuality than did compulsivity (β = .21, β = .16) among men and women, respectively. Consequently, impulsivity and compulsivity may not contribute as substantially to problematic pornography use as some scholars have proposed. On the other hand, impulsivity might have a more prominent role in hypersexuality than in problematic pornography use. Future research should examine further social and situational factors associated with problematic pornography use.

An examination of emotion-related facets of impulsivity in binge eating disorder

OBJECTIVE

While research suggests a positive association between negative urgency (NU) and binge eating, the association between positive urgency (PU) and binge eating has been less well studied. Moreover, few studies have examined NU and PU in binge eating disorder (BED). The present study examined Whiteside and Lynam's (2001) five facets of impulsivity (including NU and PU) in individuals with BED and a control group with no history of an eating disorder (NED).

METHOD

Community samples of adults with BED (n = 72) and NED (n = 79) completed self-report measures of impulsivity, eating disorder (ED) psychopathology, and symptoms of depression and anxiety.

RESULTS

The only facet of impulsivity that differed between the groups was NU, with the BED group reporting significantly higher scores on NU than the NED group. Although differences in PU initially emerged, these were no longer significant after controlling for NU. None of the impulsivity subscales predicted binge frequency, but four of the five subscales (NU, perseverance, premeditation, and PU) were significantly related to ED psychopathology.

DISCUSSION

The present findings suggest that those with BED exhibit greater NU than those without BED and that this may play role in BED symptomatology. Furthermore, the association between various impulsivity factors and ED psychopathology suggests that additional research is needed to understand these relationships in BED.

Bidirectional Relations of Impulsive Personality and Alcohol Use Across Three Waves of Data Collection

OBJECTIVE

To explore the bidirectional relations between alcohol use and three impulsive personality traits, to advance understanding of risk processes.

PARTICIPANTS

525 college students (mean age = 18.95 years) recruited in August 2008 and 2009 and followed up annually for three years.

METHODS

Personality and past/current substance use were assessed.

RESULTS

T2 sensation seeking mediated the predictive relationship between T1 and T3 alcohol use, and T2 alcohol use mediated the predictive relationship between T1 and T3 sensation seeking. In addition, T2 alcohol problems mediated the predictive relationship between T1 alcohol use and T3 negative urgency.

CONCLUSIONS

Findings support a bidirectional relationship between sensation seeking and alcohol use, and drinking anticipates drinking problems, which predict increases in negative urgency. For some individuals, there appears to be an ongoing process of increased risk in the form of increases in both drinking and high-risk personality traits.

Motives for drinking alcohol and eating palatable foods: An evaluation of shared mechanisms and associations with drinking and binge eating

BACKGROUND

Young adulthood is a high-risk period for heavy drinking and binge eating, both of which can impact weight and lead to obesity. Examining motives for drinking alcohol and eating palatable foods may facilitate a more integrated understanding of these behaviors during the college years. The current study tested whether shared or distinct (i.e., behavior-specific) motivational mechanisms may explain the occurrence of reward-driven drinking and eating in young adults.

METHODS

A sample of college freshmen (N = 103) stratified by sex, race/ethnicity, and heavy drinking status were selected to participate. Participants completed questionnaires measuring alcohol use, eating behavior, and motives assessed by the Drinking Motives Questionnaire-Revised and Palatable Eating Motives Scale. Confirmatory factor analysis (CFA) tested whether drinking and eating motives were better represented as single latent motives, or two behavior-specific motives. Structural equation modeling (SEM) was used to test the association between motivational factors and behaviors.

RESULTS

Behavior-specific CFA models demonstrated stronger model fit and higher factor loadings than single motive models. SEM models indicated that eating to cope with negative emotions, to enhance positive experiences, to obtain social reinforcement, and to conform with peers were significantly associated with binge eating (p values < .001). Enhancement and social drinking motives were significantly associated with number of weekly drinks (p values < .001).

CONCLUSIONS

While motives for drinking alcohol and eating palatable foods may satisfy common goals, findings suggest motivational mechanisms may be behavior-specific. Enhancement and social motives may be important factors to target in prevention programs for both drinking and binge eating.

Impulsivity traits and addiction-related behaviors in youth

Background and aims Impulsivity is a risk factor for addictive behaviors. The UPPS-P impulsivity model has been associated with substance addiction and gambling disorder, but its role in other non-substance addiction-related behaviors is less understood. We sought to examine associations between UPPS-P impulsivity traits and indicators of multiple substance and non-substance addiction-related behaviors in youth with varying involvement in these behaviors. Methods Participants (N = 109, aged 16-26 years, 69% males) were selected from a national survey based on their level of externalizing problems to achieve a broad distribution of involvement in addiction-related behaviors. Participants completed the UPPS-P Questionnaire and standardized questionnaires assessing problematic use of substances (alcohol, cannabis, and other drugs) and non-substances (Internet gaming, pornography, and food). Regression analyses were used to assess associations between impulsivity traits and indicators of addiction-related behaviors. Results The UPPS-P model was positively associated with indicators of all addiction-related behaviors except problematic Internet gaming. In the fully adjusted models, sensation seeking and lack of perseverance were associated with problematic use of alcohol, urgency was associated with problematic use of cannabis, and lack of perseverance was associated with problematic use of other drugs than cannabis. Furthermore, urgency and lack of perseverance were associated with binge eating and lack of perseverance was associated with problematic use of pornography. Discussion and conclusions We emphasize the role of trait impulsivity across multiple addiction-related behaviors. Our findings in at-risk youth highlight urgency and lack of perseverance as potential predictors for the development of addictions and as potential preventative therapeutic targets.

Demographic, psychiatric, and personality correlates of adults seeking treatment for disordered gambling with a comorbid binge/purge type eating disorder

Preliminary evidence suggests that binge/purge type eating disorders and gambling disorder may commonly co-occur. However, this dual-diagnosis population remains understudied. The present research examined the prevalence rates and correlates of binge/purge type eating disorders (i.e., bulimia nervosa, binge-eating disorder, and anorexia nervosa binge/purge type) among adults seeking treatment for their gambling (N = 349). In total, 11.5% of the sample (n = 40) met criteria for a binge/purge type eating disorder, most commonly bulimia nervosa (n = 33). There was a higher preponderance of binge/purge type eating disorders in women. People with a comorbid binge/purge type eating disorder reported more days gambling, gambling-related cognitive distortions, impulsivity, suicidality, and other current psychiatric comorbidities including addictive behaviours. These findings suggest that binge/purge type eating disorders in people seeking treatment for gambling may be more common than previously believed. Furthermore, the increased psychopathology among people with binge/purge type eating disorder and gambling disorder identify vulnerabilities of this dual-diagnosed population that may require clinical attention.

Family Socioeconomic Status at Birth and Youth Impulsivity at Age 15; Blacks' Diminished Return

Minorities&rsquo; Diminished Return theory suggests that health effects of socioeconomic status (SES) are systemically smaller for racial and ethnic minorities compared to Whites. To test the relevance of Minorities&rsquo; Diminished Return theory for youth impulsivity, we investigated Black⁻White differences in the effects of family SES at birth on subsequent youth impulsivity at age 15. Data came from the Fragile Families and Child Wellbeing Study (FFCWS), 1998⁻2016, a 15-year longitudinal study of urban families from the birth of their children to age 15. This analysis included 1931 families who were either White (n = 495) or Black (n = 1436). The independent variables of this study were family income, maternal education, and family structure at birth. Youth impulsivity at age 15 was the dependent variable. Gender was the covariate and race was the focal moderator. We ran linear regressions in the overall sample and specific to each race. In the overall sample, higher household income (b = &minus;0.01, 95% CI = &minus;0.01 to 0.00) and maternal education (b = &minus;0.24, 95% CI = &minus;0.44 to &minus;0.04) at birth were associated with lower youth impulsivity at age 15, independent of race, gender, and family structure. A significant interaction was found between race and household income at birth (b = 0.01, 95% CI = 0.00 to 0.02) on subsequent youth impulsivity, which was indicative of a stronger protective effect for Whites compared to Blacks. Blacks&rsquo; diminished return exists for the long-term protective effects of family income at birth against subsequent youth impulsivity. The relative disadvantage of Blacks in comparison to Whites is in line with a growing literature showing that Black families gain less from high SES, which is possibly due to the existing structural racism in the US.

Impulsivity as a mediator in the relationship between problem solving and suicidal ideation

OBJECTIVE

This study examined whether three facets of impulsivity previously shown to be associated with suicidal ideation and attempts (negative urgency, lack of premeditation, and lack of perseverance) help to account for the established association between problem solving deficits and suicidal ideation.

METHOD

Emerging adult college student drinkers with a history of at least passive suicidal ideation (N = 387) completed measures of problem solving, impulsivity, and suicidal ideation. A path analysis was conducted to examine the mediating role of impulsivity variables in the association between problem solving (rational problem solving, positive and negative problem orientation, and avoidance style) and suicidal ideation.

RESULTS

Direct and indirect associations through impulsivity, particularly negative urgency, were found between problem solving and severity of suicidal ideation.

CONCLUSIONS

Interventions aimed at teaching problem solving skills, as well as self-efficacy and optimism for solving life problems, may help to reduce impulsivity and suicidal ideation.

On the Determinants and Outcomes of Passion for Playing Pokémon Go

In 2016, Pokémon Go became the most popular smartphone game. Despite the increasing popularity of this augmented reality game, to date, no studies have investigated passion for playing Pokémon Go. On the theoretical basis of the Dualistic Model of Passion (DMP), our goal was to investigate the associations between Pokémon Go playing motives, passion, and impulsivity. A total of 621 Pokémon Go players participated in the study (54.9% female; M_age = 22.6 years, SD_age = 4.4). It was found that impulsivity was more strongly associated with obsessive passion (OP) than with harmonious passion (HP). HP was associated with adaptive motives (i.e., outdoor activity, social, recreation, and nostalgia), while OP was associated with less adaptive motives (i.e., fantasy, escape, boredom, competition, and coping). Therefore, in line with the DMP, HP and OP for playing Pokémon Go can predict an almost perfectly distinguished set of adaptive or maladaptive playing motives, and OP has a noteworthy relationship with impulsivity as a determinant.

[Smartphone addiction: French validation of the Internet Addiction Test-Smartphone version (IAT-smartphone) and associated psychopathological features]

INTRODUCTION

Since their first appearance in 1992 smartphones have improved constantly, and their use, combined with the rapid spread of the Internet, has increased dramatically. The recent emergence of this technology raises new issues, at both individual and societal levels. Several studies have investigated the physical and psychological harm that may be caused by smartphones. The issue of excessive smartphone use as an addictive disorder is frequently raised and debated, although it is not acknowledged in international classifications. In France, there is no validated assessment tool for smartphone addiction. Therefore, the aims of this research were: to validate a French translation of the Internet Addiction Test-smartphone version (IAT-smartphone); to study the links between smartphone addiction, Internet addiction, depression, anxiety and impulsivity.

METHOD

Two hundred and sixteen participants from the general population were included in the study (January to February 2016), which was available online using Sphinx software. We assessed smartphone addiction (French version of the Internet Addiction Scale - smartphone version, IAT-smartphone), specificity of smartphone use (time spent, types of activity), Internet addiction (Internet Addiction Test, IAT), impulsivity (UPPS Impulsiveness Behavior Scale), and anxiety and depression (Hospital Anxiety and Depression scale, HAD). We tested the construct validity of the IAT-smartphone (exploratory factor analysis, internal consistency, non-parametric correlation tests for convergent validity). We also carried out multiple linear regressions to determine the factors associated with IAT-smartphone.

RESULTS

Mean age was 32.4±12.2 years; 75.5% of the participants were women. The IAT-smartphone had a one-factor structure (explaining 42 % of the variance), excellent internal consistency (α=0.93) and satisfactory convergent validity. Smartphone addiction was associated with Internet addiction (ρ=0.85), depression (ρ=0.31), anxiety (ρ=0.14), and some impulsivity subscales, including "negative urgency" (ρ=0.20; P<0.01), "positive urgency" (ρ=0.20; P<0.01), and "lack of perseverance" (ρ=0.16; P<0.05). Age was negatively associated with the IAT-S total score (ρ=-0.25; P<0.001), and there was a non-significant difference between the IAT-S total scores of men and women (29.3±10.2 vs. 32.7±12.4; P=0.06). Multiple linear regression showed that age, anxiety, depression, average time spent on the smartphone, impulsivity and Internet addiction explained 71.4 % of the variance of IAT-smartphone scores. However, this score dropped to 13.2 % when Internet addiction was removed from the model. This variable alone explained 70.8 % of the IAT-smartphone scores.

CONCLUSION

The French version of the IAT-smartphone is a reliable and valid questionnaire to assess smartphone addiction. This addiction appears to be strongly linked to anxiety, depression and impulsivity. The strong association between smartphone addiction and Internet addiction suggests that smartphone addiction is one of the many forms of Internet addiction. In fact, smartphones may not be the object of the addiction but rather a medium facilitating Internet access as it makes it possible to connect anywhere anytime. This raises the issue of the potential role of smartphones in speeding up and facilitating the development of Internet addiction.

Negative urgency partially accounts for the relationship between major depressive disorder and marijuana problems

BACKGROUND

To goal of this study was to better understand mechanisms underlying associations between Major Depressive Disorder (MDD) and marijuana use and problems. Specifically, it was hypothesized that negative urgency (NU), the tendency to act rashly while experiencing negative mood states, would uniquely (compared to other impulsivity traits: positive urgency, sensation seeking, premeditation, and perseverance) account for the relationship between MDD and marijuana use and problems.

METHODS

Data were collected from a sample (N = 357) of veterans (M age = 33.63) recruited from a Veterans Affairs hospital who used marijuana at least once in their lifetime. Participants completed the SCID-NP to assess MDD, a marijuana problems scale, a Time-Line Follow-back to assess six-month marijuana use, and the UPPS-P Impulsive Behavior Scale for impulsivity.

RESULTS

Path analysis was conducted using bootstrapped (k = 20,000) and bias-corrected 95% confidence intervals (CIs) to estimate mediation (indirect) effects, controlling for age, sex, and race. Analyses revealed a significant direct effect of MDD on NU and NU on marijuana problems. Regarding mediational analyses, there was a significant indirect effect of MDD on marijuana problems via NU. The direct effect of MDD on marijuana problems was reduced, but remained significant, suggesting partial mediation. No other impulsivity scales accounted for the relationship between MDD and marijuana problems. In predicting marijuana use, there were no significant indirect effects for any impulsivity traits, including NU, despite significant bivariate associations between use and NU and MDD.

CONCLUSIONS

Results suggest that high levels of NU may partially explain associations between MDD and marijuana problems, but not marijuana use. No other facets of impulsivity accounted for the relationship between MDD and marijuana use or problems, underscoring the specificity of NU as a putative mechanism and the importance of assessing NU in treatment settings.

Negative urgency and expectancies increase vulnerability to binge eating in bulimia nervosa

Negative urgency (NU), the tendency to act impulsively when distressed, is associated with binge eating. Women who believe that eating alleviates negative affect are also more likely to binge eat. Thus, it is hypothesized that the individuals with high levels of NU, and who endorse these eating expectancies, will binge eat the following acute distress. This study tested these hypotheses using ecological momentary assessment. Sixteen women with the symptoms of BN completed clinical assessments, and were asked to report on distress and binges multiple times daily for two weeks. NU moderated the temporal relationship of negative affect to binges, such that women with lower scores on NU experienced a sharper increase in affect prior to binges. Individual differences in eating expectancies also moderated the relationship of affect to binge eating. Results suggest that women with high levels of NU and expectancy endorsement are triggered to binge by smaller shifts in negative affect than women who do not endorse these traits.

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.

Distorted Beliefs about Luck and Skill and Their Relation to Gambling Problems and Gambling Behavior in Dutch Gamblers

Gamblers' cognitive distortions are thought to be an important mechanism involved in the development and maintenance of problem gambling. The Gambling Cognitions Inventory (GCI) evaluates two categories of distortions: beliefs that one is lucky (i.e., "Luck/Chance") and beliefs that one has special gambling-related skills (i.e., "Skill/Attitude"). Prior psychometric evaluations of the GCI demonstrated the utility of both subscales as measures of distortions and their concurrent relations to gambling problems among Canadian gamblers. However, these associations have not yet been studied in gamblers from other cultures nor have relationships between the GCI and indices of gambling behavior been investigated. In addition, the predictive validity of the GCI scales have not been evaluated in studies to date. The present study investigated the validity of the GCI as a measure of cognitive distortions in a sample of 49 Dutch gamblers by examining its concurrent and prospective relationships to both gambling problems (as measured through a standardized nine-item questionnaire assessing gambling-related problems) and behaviors (as measured through two variables: days spent gambling and time spent gambling in minutes) at baseline and over 1-month and 6-month intervals. The GCI subscales were internally consistent at all timepoints, and moderately to strongly inter-correlated at all timepoints. Each subscale correlated with an independent dimension of gambling both concurrently and prospectively: Luck/Chance was related to greater gambling problems and Skill/Attitude was related to greater gambling behavior. Thus, the two GCI subscales, while inter-correlated, appear to be related to different gambling outcomes, at least among Dutch gamblers. Moreover, the first evidence of the predictive validity of the GCI scales was demonstrated over a 1-month and 6-month interval. It is recommended that both types of cognitive distortions be considered in research and clinical practice to fully understand and address individual risk for excessive and problematic gambling.

Impulsivity and history of behavioral addictions are associated with drug use in adolescents

BACKGROUND

Previous literature suggests that trait impulsivity and engagement in non-drug-related behavioral addictions (e.g., Internet addiction, food addiction) are two risk factors for drug use. Here we further investigated the potential impact of having one or both of these risk factors on drug use in Los Angeles area adolescents.

METHOD

High school students (N=1612; Mean age=14.1) completed self-report surveys measuring two potential risk factors (impulsivity, lifetime history of several behavioral addictions), and past 6-month use of tobacco, alcohol and marijuana. Participants who reported never using drugs completed questionnaires assessing their susceptibility for future use.

RESULTS

In general, adolescents who endorsed either impulsivity alone or at least two behavioral addictions alone were more likely to have used tobacco, alcohol, or marijuana compared to individuals who had neither risk factor (OR=2.50-4.13), and individuals who endorsed both impulsivity and three or more behavioral addictions were the most likely to have used these drugs (OR=9.40-10.13). Similarly, among those who had never tried a drug, individuals with this combined set of risk factors were the most likely to be susceptible to future drug use (OR=3.37-5.04).

DISCUSSION

These results indicate that the combination of trait impulsivity and a history of behavioral addictions increases the risk for current and future drug use in adolescents, to a greater extent than either risk factor alone. It may be useful for drug prevention efforts to target impulsive adolescents who also actively engage in other non-drug-related addictive behaviors.

Correlation between Traits of Emotion-Based Impulsivity and Intrinsic Default-Mode Network Activity

Negative urgency (NU) and positive urgency (PU) are implicated in several high-risk behaviors, such as eating disorders, substance use disorders, and nonsuicidal self-injury behavior. The current study aimed to explore the possible link between trait of urgency and brain activity at rest. We assessed the amplitude of low-frequency fluctuations (ALFF) of the resting-state functional magnetic resonance imaging (fMRI) signal in 85 healthy volunteers. Trait urgency measures were related to ALFF in the lateral orbitofrontal cortex, dorsolateral prefrontal cortex, ventral and dorsal medial frontal cortex, anterior cingulate, and posterior cingulate cortex/precuneus. In addition, trait urgency measures showed significant correlations with the functional connectivity of the posterior cingulate cortex/precuneus seed with the thalamus and midbrain region. These findings suggest an association between intrinsic brain activity and impulsive behaviors in healthy humans.

Social exposure and emotion dysregulation: Main effects in relation to nonsuicidal self-injury

We examined the relation of interpersonal and media exposure to nonsuicidal self-injury (NSSI) among 340 university students in the southeastern United States (73.5% female, M age = 19.38 years, SD = 1.15). We also assessed interactions and main effects of each exposure and emotion dysregulation in relation to NSSI, testing the social learning hypothesis of NSSI. Most participants endorsed medium to high levels of exposure to NSSI via media sources. More than one-third of participants were somewhat or very familiar with someone who engaged in NSSI. Almost half reported occasional or frequent conversations about NSSI. Both exposure forms were significantly related to NSSI history. However, hurdle regression analyses revealed that interpersonal exposure and emotion dysregulation, but not media exposure, were significantly associated with NSSI history and frequency. We did not find evidence for an emotion dysregulation-by-interpersonal-exposure interaction. We discuss implications for theoretical models of NSSI, limitations, and future directions.