1
|
Kiser ET, Sinclair KL, Tullos EA, Ratcliff CG. Associations between disordered eating and body focused repetitive behaviors in college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:1184-1191. [PMID: 35549835 DOI: 10.1080/07448481.2022.2070713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 12/21/2021] [Accepted: 04/13/2022] [Indexed: 06/15/2023]
Abstract
Objective: College students with disordered eating (DE) are at increased risk of body focused repetitive behaviors (BFRBs). Both DE and BFRBs are described as impulsive and compulsive. However, the associations of impulsive DE with impulsive BFRBs and compulsive DE with compulsive BFRBs have not been examined. Methods: 191 college-aged students completed a survey of BFRBs and DE. Results: Participants who reported hair pulling were twice as likely to report clinically significant DE than those who denied hair pulling (p = .022). Participants who endorsed distressing hair pulling (p = .026), skin picking (p = .052), and nail biting (p = .094) were twice as likely to report clinically significant DE than those who were not distressed by these behaviors. Evidence did not support the association of BFRBs and DE along an impulsive/compulsive continuum. Conclusions: Results suggest that BFRBs and DE often co-occur, and the role of impulsivity and compulsivity in these behaviors is complex.
Collapse
Affiliation(s)
- Emalee T Kiser
- Department of Psychology, Sam Houston State University, Huntsville, Texas, USA
| | - Kelsey L Sinclair
- Department of Psychology, Sam Houston State University, Huntsville, Texas, USA
| | - Emily A Tullos
- Department of Psychology, Sam Houston State University, Huntsville, Texas, USA
| | - Chelsea G Ratcliff
- Department of Psychology, Sam Houston State University, Huntsville, Texas, USA
| |
Collapse
|
2
|
Jones JA, Belin-Rauscent A, Jupp B, Fouyssac M, Sawiak SJ, Zuhlsdorff K, Zhukovsky P, Hebdon L, Velazquez Sanchez C, Robbins TW, Everitt BJ, Belin D, Dalley JW. Neurobehavioral Precursors of Compulsive Cocaine Seeking in Dual Frontostriatal Circuits. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2024; 4:194-202. [PMID: 38298793 PMCID: PMC10829640 DOI: 10.1016/j.bpsgos.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 06/04/2023] [Accepted: 06/09/2023] [Indexed: 02/02/2024] Open
Abstract
Background Only some individuals who use drugs recreationally eventually develop a substance use disorder, characterized in part by the rigid engagement in drug foraging behavior (drug seeking), which is often maintained in the face of adverse consequences (i.e., is compulsive). The neurobehavioral determinants of this individual vulnerability have not been fully elucidated. Methods Using a prospective longitudinal study involving 39 male rats, we combined multidimensional characterization of behavioral traits of vulnerability to stimulant use disorder (impulsivity and stickiness) and resilience (sign tracking and sensation seeking/locomotor reactivity to novelty) with magnetic resonance imaging to identify the structural and functional brain correlates of the later emergence of compulsive drug seeking in drug-naïve subjects. We developed a novel behavioral procedure to investigate the individual tendency to persist in drug-seeking behavior in the face of punishment in a drug-free state in subjects with a prolonged history of cocaine seeking under the control of the conditioned reinforcing properties of a drug-paired Pavlovian conditioned stimulus. Results In drug-naïve rats, the tendency to develop compulsive cocaine seeking was characterized by behavioral stickiness-related functional hypoconnectivity between the prefrontal cortex and posterior dorsomedial striatum in combination with impulsivity-related structural alterations in the infralimbic cortex, anterior insula, and nucleus accumbens. Conclusions These findings show that the vulnerability to developing compulsive cocaine-seeking behavior stems from preexisting structural or functional changes in two distinct corticostriatal systems that underlie deficits in impulse control and goal-directed behavior.
Collapse
Affiliation(s)
- Jolyon A. Jones
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Downing Site, Cambridge, United Kingdom
| | - Aude Belin-Rauscent
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Downing Site, Cambridge, United Kingdom
| | - Bianca Jupp
- Department of Neurosciences, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Maxime Fouyssac
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Downing Site, Cambridge, United Kingdom
| | - Stephen J. Sawiak
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Downing Site, Cambridge, United Kingdom
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, United Kingdom
| | - Katharina Zuhlsdorff
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Downing Site, Cambridge, United Kingdom
| | - Peter Zhukovsky
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Lara Hebdon
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Downing Site, Cambridge, United Kingdom
| | - Clara Velazquez Sanchez
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Downing Site, Cambridge, United Kingdom
| | - Trevor W. Robbins
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Downing Site, Cambridge, United Kingdom
| | - Barry J. Everitt
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Downing Site, Cambridge, United Kingdom
| | - David Belin
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Downing Site, Cambridge, United Kingdom
| | - Jeffrey W. Dalley
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Downing Site, Cambridge, United Kingdom
- Department of Psychiatry, Herschel Smith Building for Brain and Mind Sciences, Forvie Site, Cambridge, United Kingdom
| |
Collapse
|
3
|
Namlı Z, Tamam L, Demirkol ME, Karaytuğ MO, Sun T. The Relationship Among Autistic Traits, Impulsivity, and Functionality in Patients With Obsessive-Compulsive Disorder. J Nerv Ment Dis 2023; 211:195-202. [PMID: 36191327 DOI: 10.1097/nmd.0000000000001601] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT Obsessive-compulsive disorder (OCD) is a chronic mental disorder that causes disabilities. This study investigated the relationship among impulsivity, autistic traits, and disabilities in patients with OCD. We included 88 patients with OCD and 90 healthy volunteers without any mental disorders. The participants were evaluated using the Yale-Brown Obsessive-Compulsive Scale, Autism Spectrum Quotient (AQ), Barratt Impulsiveness Scale-11 (BIS-11), and World Health Organization Disability Assessment Schedule (WHODAS 2.0). Regression analyses revealed that AQ-attention switching and BIS-attentional subscale scores were associated with WHODAS-overall score in the OCD group ( p = 0.017 and p = 0.034, respectively). In the OCD group, AQ total, social skills, and communication subdomain scores partially mediated the relationship between impulsivity and disability. BIS total, attentional, and nonplanning subscale scores partially mediated the relationship between autistic traits and disability. Developing new treatment strategies for cognitive recovery, in addition to traditional treatment approaches in patients with OCD, may help increase functionality in patients with OCD.
Collapse
Affiliation(s)
- Zeynep Namlı
- Department of Psychiatry, Çukurova University Medical School, Adana, Turkey
| | | | | | | | | |
Collapse
|
4
|
Grant JE, Valle S, Chamberlain SR. Nutrition in Skin Picking Disorder and Trichotillomania. Front Psychiatry 2021; 12:761321. [PMID: 34887788 PMCID: PMC8650212 DOI: 10.3389/fpsyt.2021.761321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 10/29/2021] [Indexed: 12/15/2022] Open
Abstract
Objective: Excessive calorie intake constitutes a global public health concern, due to its associated range of untoward outcomes. Impulsivity and compulsivity have been linked to dietary intake. However, nothing is known about dietary intake and body-focused repetitive behaviors, despite their classification as obsessive-compulsive related conditions, and high co-morbidity with impulsive and compulsive conditions. Methods: One hundred and ninety six adults with trichotillomania or skin picking disorder were recruited. Dietary intake over the preceding year was quantified using the Dietary Fat and Free Sugar Short questionnaire. Relationships between dietary fat/sugar intake and behaviors were evaluated using regression modeling. Results: Sugar intake was significantly related to higher trans-diagnostic compulsivity (p = 0.011) and higher non-planning impulsivity (p = 0.013) In terms of saturated fat intake, there was no significant relationship to the explanatory variables. A combination high fat/high sugar diet was significantly associated with higher motor impulsivity (p = 0.005). Conclusions: Past-year nutrition appears to be significantly associated with trans-diagnostic impulsivity and compulsivity. The role of poor nutrition in these disorders and related conditions, and its link with impulsivity and compulsivity, requires longitudinal research attention; and clinical work should address not only psychiatric symptoms but also impact of lifestyle of overall health.
Collapse
Affiliation(s)
- Jon E. Grant
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, United States
| | - Stephanie Valle
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, United States
| | - Samuel R. Chamberlain
- Department of Psychiatry, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
- Southern Health NHS Foundation Trust, Southampton, United Kingdom
| |
Collapse
|
5
|
Abstract
OBJECTIVE To (1) confirm whether the Habit, Reward, and Fear Scale is able to generate a 3-factor solution in a population of obsessive-compulsive disorder and alcohol use disorder (AUD) patients; (2) compare these clinical groups in their habit, reward, and fear motivations; and (3) investigate whether homogenous subgroups can be identified to resolve heterogeneity within and across disorders based on the motivations driving ritualistic and drinking behaviors. METHODS One hundred and thirty-four obsessive-compulsive disorder (n = 76) or AUD (n = 58) patients were assessed with a battery of scales including the Habit, Reward, and Fear Scale, the Yale-Brown Obsessive-Compulsive Scale, the Alcohol Dependence Scale, the Behavioral Inhibition/Activation System Scale, and the Urgency, (lack of ) Premeditation, (lack of ) Perseverance, Sensation Seeking, and Positive Urgency Impulsive Behavior Scale. RESULTS A 3-factor solution reflecting habit, reward, and fear subscores explained 56.6% of the total variance of the Habit, Reward, and Fear Scale. Although the habit and fear subscores were significantly higher in obsessive-compulsive disorder (OCD) and the reward subscores were significantly greater in AUD patients, a cluster analysis identified that the 3 clusters were each characterized by differing proportions of OCD and AUD patients. CONCLUSIONS While affective (reward- and fear-driven) and nonaffective (habitual) motivations for repetitive behaviors seem dissociable from each other, it is possible to identify subgroups in a transdiagnostic manner based on motivations that do not match perfectly motivations that usually described in OCD and AUD patients.
Collapse
|
6
|
Fontenelle LF, Destrée L, Brierley ME, Thompson EM, Yücel M, Lee R, Albertella L, Chamberlain SR. The place of obsessive-compulsive and related disorders in the compulsive-impulsive spectrum: a cluster-analytic study. CNS Spectr 2021:1-10. [PMID: 33843555 DOI: 10.1017/s109285292100033x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND The extent to which obsessive-compulsive and related disorders (OCRDs) are impulsive, compulsive, or both requires further investigation. We investigated the existence of different clusters in an online nonclinical sample and in which groups DSM-5 OCRDs and other related psychopathological symptoms are best placed. METHODS Seven hundred and seventy-four adult participants completed online questionnaires including the Cambridge-Chicago Compulsivity Trait Scale (CHI-T), the Barratt Impulsiveness Scale (BIS-15), and a series of DSM-5 OCRDs symptom severity and other psychopathological measures. We used K-means cluster analysis using CHI-T and BIS responses to test three and four factor solutions. Next, we investigated whether different OCRDs symptoms predicted cluster membership using a multinomial regression model. RESULTS The best solution identified one "healthy" and three "clinical" clusters (ie, one predominantly "compulsive" group, one predominantly "impulsive" group, and one "mixed"-"compulsive and impulsive group"). A multinomial regression model found obsessive-compulsive, body dysmorphic, and schizotypal symptoms to be associated with the "mixed" and the "compulsive" clusters, and hoarding and emotional symptoms to be related, on a trend level, to the "impulsive" cluster. Additional analysis showed cognitive-perceptual schizotypal symptoms to be associated with the "mixed" but not the "compulsive" group. CONCLUSIONS Our findings suggest that obsessive-compulsive disorder; body dysmorphic disorder and schizotypal symptoms can be mapped across the "compulsive" and "mixed" clusters of the compulsive-impulsive spectrum. Although there was a trend toward hoarding being associated with the "impulsive" group, trichotillomania, and skin picking disorder symptoms did not clearly fit to the demarcated clusters.
Collapse
Affiliation(s)
- Leonardo F Fontenelle
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ)
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Louise Destrée
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Mary-Ellen Brierley
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Emma M Thompson
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Murat Yücel
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Rico Lee
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Lucy Albertella
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Sam R Chamberlain
- Department of Psychiatry, University of Southampton; and Department of Psychiatry, University of Cambridge, UK
| |
Collapse
|
7
|
Berengüí R, López-Gullón JM, Angosto S. Physical Sports Activities and Exercise Addiction during Lockdown in the Spanish Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3119. [PMID: 33803533 PMCID: PMC8003043 DOI: 10.3390/ijerph18063119] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/12/2021] [Accepted: 03/16/2021] [Indexed: 12/29/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has led to the paralysis of the worldwide economy caused by the population's lockdown to stop the virus spreading, making it difficult to do exercise. The aim of this study is to analyse the commitment to and feeling of insecurity related to practising sport, sports habits and the profile of the Spanish population during lockdown according to the level of addiction to exercise. The sample consisted of 1019 subjects with a mean age of 35 years old. The variables analysed were exercise addiction, commitment to and feeling of insecurity related to sport, and sport habits. Three groups were identified according to their addiction level to exercise: asymptomatic (n = 202), symptomatic (n = 756), and at risk of addiction (n = 61). The main results indicated that a higher addiction level was associated with a higher number of days and time spent on exercise per week. Six percent of the subjects were at addiction risk, and they had a lower feeling of insecurity towards sport. These findings provide information to governments on the need to promote physical activity programmes at home to promote adequate fitness and mental wellbeing in the population.
Collapse
Affiliation(s)
- Rosendo Berengüí
- Faculty of Social Sciences and Communication, Catholic University of Murcia, 30107 Guadalupe, Spain;
| | | | - Salvador Angosto
- Faculty of Sport Sciences, University of Murcia, 30720 Santiago de la Ribera, Spain;
| |
Collapse
|
8
|
Torales J, González I, Castaldelli-Maia JM, Ventriglio A. Kleptomania as a neglected disorder in psychiatry. Int Rev Psychiatry 2020; 32:451-454. [PMID: 32401643 DOI: 10.1080/09540261.2020.1756635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Kleptomania is an impulse control disorder characterized by the irresistible urge to steal not for monetary gain. Since its conceptualization, this categorical diagnosis has been conflated with common beliefs regarding the social class and gender such as the idea that women are intrinsically fragile and that people in the middle class were unlikely to commit theft. Also, its use has been controversial in the medical and forensic fields. This review of the literature will provide a historical excursus through the definitions of the syndrome and summarize the available pharmacological and psychotherapeutic options for its treatment. Currently, there is a lack of systematic studies regarding the clinical characteristics of kleptomania and its treatment options for practical standardized approaches.
Collapse
Affiliation(s)
- Julio Torales
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, Asunción, Paraguay
| | - Israel González
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, Asunción, Paraguay
| | - João Mauricio Castaldelli-Maia
- Department of Neuroscience, ABC Health University Center, Santo André, Brazil.,Department of Psychiatry, Medical School, University of São Paulo, São Paulo, Brazil
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| |
Collapse
|
9
|
Kapitány-Fövény M, Urbán R, Varga G, Potenza MN, Griffiths MD, Szekely A, Paksi B, Kun B, Farkas J, Kökönyei G, Demetrovics Z. The 21-item Barratt Impulsiveness Scale Revised (BIS-R-21): An alternative three-factor model. J Behav Addict 2020; 9:225-246. [PMID: 32609636 PMCID: PMC8939423 DOI: 10.1556/2006.2020.00030] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 01/04/2020] [Accepted: 04/04/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND AND AIMS Due to its important role in both healthy groups and those with physical, mental and behavioral disorders, impulsivity is a widely researched construct. Among various self-report questionnaires of impulsivity, the Barratt Impulsiveness Scale is arguably the most frequently used measure. Despite its international use, inconsistencies in the suggested factor structure of its latest version, the BIS-11, have been observed repeatedly in different samples. The goal of the present study was therefore to test the factor structure of the BIS-11 in several samples. METHODS Exploratory and confirmatory factor analyses were conducted on two representative samples of Hungarian adults (N = 2,457; N = 2,040) and a college sample (N = 765). RESULTS Analyses did not confirm the original model of the measure in any of the samples. Based on explorative factor analyses, an alternative three-factor model (cognitive impulsivity; behavioral impulsivity; and impatience/restlessness) of the Barratt Impulsiveness Scale is suggested. The pattern of the associations between the three factors and aggression, exercise, smoking, alcohol use, and psychological distress supports the construct validity of this new model. DISCUSSION The new measurement model of impulsivity was confirmed in two independent samples. However, it requires further cross-cultural validation to clarify the content of self-reported impulsivity in both clinical and nonclinical samples.
Collapse
Affiliation(s)
- Máté Kapitány-Fövény
- Faculty of Health Sciences, Semmelweis University, Budapest, Hungary,Nyírő Gyula National Institute of Psychiatry and Addictions, Budapest, Hungary,Corresponding author. E-mail: Tel.: +36 20 522 1850
| | - Róbert Urbán
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Gábor Varga
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Marc N. Potenza
- Yale School of Medicine, Connecticut Council on Problem Gambling and Connecticut Mental Health Center, New Haven, CT, USA
| | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Anna Szekely
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Borbála Paksi
- Institute of Education, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Bernadette Kun
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Judit Farkas
- Nyírő Gyula National Institute of Psychiatry and Addictions, Budapest, Hungary,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Gyöngyi Kökönyei
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary,Corresponding author. E-mail:
| |
Collapse
|
10
|
Abstract
Gambling addiction (GA) is now considered a worldwide health issue. Although the topic of disorder awareness is a central issue in clinical practice, there are few studies examining this dimension in relation to GA. To bridge this gap, we conducted a qualitative study, administering interviews focused on awareness of GA and eliciting narratives of both the disorder and the whole life of participants. We adopted both qualitative and quantitative methods of research, using computer-aided content analysis. We administered to a sample of 15 treatment-seeking gamblers the Psychiatric Interview for Gambling Addiction and performed a qualitative analysis of the text using the T-Lab software. Five main thematic domains and four factors emerged, shedding light on specific aspects underlying the development of and recovery from GA. Specifically, the results suggested that dissociation processes, materialistic thinking and difficulties in social achievement underlie the subjective experience of GA. Moreover, closeness in interpersonal relationships and awareness of the disorder emerged as core features in the process of change. As a whole, the results highlight the specificities of disorder awareness in addicted gamblers. We discuss these results within the context of previous research and suggest clinical implications for the treatment of GA.
Collapse
|
11
|
Nadeau MM, Rochlen AB, Tyminski R. The Psychology of Shoplifting: Development of a New Typology for Repeated Shoplifting. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2019; 63:2338-2355. [PMID: 31043101 DOI: 10.1177/0306624x19845979] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Despite the damaging effects of shoplifting on individuals, the current literature offers little guidance for changing shoplifting behavior. One limitation in this area of research has been the failure to use empirically and theoretically sound methodologies to identify individuals' diverse characteristics and motivations. The present study addressed these limitations by developing an empirically and theoretically supported typology of the varied individuals who shoplift. Participants included 202 community individuals who reported repeated shoplifting and provided information about their shoplifting behavior, motivations, mental health, ethical attitudes, personal histories, and life circumstances. Cluster analyses revealed that the sample could be divided into six discrete groups. These clusters comprise a typology of shoplifting, including Loss-Reactive (28% of the sample), Impulsive (20%), Depressed (18%), Hobbyist (18%), Addictive-Compulsive (9%), and Economically Disadvantaged (7%) types. Each type comprises a unique pattern of shoplifting with unique needs. This research establishes a promising foundation for treating the diverse individuals who shoplift.
Collapse
|
12
|
Luigjes J, Lorenzetti V, de Haan S, Youssef GJ, Murawski C, Sjoerds Z, van den Brink W, Denys D, Fontenelle LF, Yücel M. Defining Compulsive Behavior. Neuropsychol Rev 2019; 29:4-13. [PMID: 31016439 PMCID: PMC6499743 DOI: 10.1007/s11065-019-09404-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 03/27/2019] [Indexed: 11/25/2022]
Abstract
Compulsive tendencies are a central feature of problematic human behavior and thereby are of great interest to the scientific and clinical community. However, no consensus exists about the precise meaning of ‘compulsivity,’ creating confusion in the field and hampering comparison across psychiatric disorders. A vague conceptualization makes compulsivity a moving target encompassing a fluctuating variety of behaviors, which is unlikely to improve the new dimension-based psychiatric or psychopathology approach. This article aims to help progress the definition of what constitutes compulsive behavior, cross-diagnostically, by analyzing different definitions in the psychiatric literature. We searched PubMed for articles in human psychiatric research with ‘compulsive behavior’ or ‘compulsivity’ in the title that focused on the broader concept of compulsivity—returning 28 articles with nine original definitions. Within the definitions, we separated three types of descriptive elements: phenomenological, observational and explanatory. The elements most applicable, cross-diagnostically, resulted in this definition: Compulsive behavior consists of repetitive acts that are characterized by the feeling that one ‘has to’ perform them while one is aware that these acts are not in line with one’s overall goal. Having a more unified definition for compulsive behavior will make its meaning precise and explicit, and therefore more transferable and testable across clinical and non-clinical populations.
Collapse
Affiliation(s)
- Judy Luigjes
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, PA3.227, PO Box 22660, 1100DD, Amsterdam, The Netherlands. .,Brain Imaging Center, Academic Medical Center, Amsterdam UMC, Amsterdam, The Netherlands.
| | | | - Sanneke de Haan
- Culture Studies, Tilburg University, Tilburg, The Netherlands
| | - George J Youssef
- School of Psychology, Deakin University, Geelong, Australia.,Murdoch Childrens Research Institute, Population Studies of Adolescents, The Royal Children's Hospital Melbourne, Parkville, Australia
| | - Carsten Murawski
- Department of Finance, The University of Melbourne, Parkville, Victoria, Australia
| | - Zsuzsika Sjoerds
- Institute of Psychology, Cognitive Psychology Unit & Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands.,Department of Neurology, Max-Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Wim van den Brink
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, PA3.227, PO Box 22660, 1100DD, Amsterdam, The Netherlands
| | - Damiaan Denys
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, PA3.227, PO Box 22660, 1100DD, Amsterdam, The Netherlands.,Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | - Leonardo F Fontenelle
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.,D'Or Institute for Research and Education, Rio de Janeiro, Brazil.,Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Murat Yücel
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|
13
|
Järvinen A, Laine MK, Tikkanen R, Castrén ML. Beneficial Effects of GLP-1 Agonist in a Male With Compulsive Food-Related Behavior Associated With Autism. Front Psychiatry 2019; 10:97. [PMID: 30881319 PMCID: PMC6405420 DOI: 10.3389/fpsyt.2019.00097] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 02/11/2019] [Indexed: 11/22/2022] Open
Abstract
Individuals with autism spectrum disorder (ASD) frequently display intensely repetitive, restricted thoughts, and behaviors. These behaviors have similarities to compulsions and/or obsessions in obsessive compulsive disorder (OCD) and are primarily treated with behaviourally-based interventions and serotonin uptake inhibitors (SSRIs). Due to the lack of treatment responses in many cases, however, new treatments are being sought. Here we report beneficial effects of treatment with liraglutide, a glucagon-like peptide-1 (GLP-1) analog, on severe obsessive food craving, binge eating, weight gain, and behavioral problems in an adolescent male with infantile autism and moderate intellectual impairment. Liraglutide treatment reduced weight and unwanted behavior seemingly by preventing food-related repetitive thoughts and compulsions. Our report provides clinical evidence that GLP-1 signaling pathway may represent a novel target for treating food-related behavioral problems and aggressive behavior in ASD.
Collapse
Affiliation(s)
| | | | - Roope Tikkanen
- Department of Psychiatry, University of Helsinki, Helsinki, Finland
| | - Maija L Castrén
- Autism Foundation, Helsinki, Finland.,Department of Physiology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| |
Collapse
|
14
|
Abstract
Background Pyromania is a rare disorder that is characterized by multiple episodes of deliberate and purposeful fire-setting. It is typically associated with significant psychosocial dysfunction and legal problems. Even so, little research has examined cognitive aspects of the disorder. Case presentation/study In this study, we compared a 24-year-old woman with pyromania with 19 age- and gender-matched healthy controls using a battery of computerized neurocognitive tasks. Our participant affected by pyromania showed impaired cognitive flexibility but intact functioning on measures of impulsive action and decision-making. Discussion Although pyromania shares phenomenological similarities with other urge-driven disorders, our results suggest that pyromania may have features of compulsivity as well. Conclusions Pyromania is relatively understudied from a neurobiological perspective. Further research is needed to understand the pathophysiology, classification, and treatment of pyromania.
Collapse
Affiliation(s)
- Austin W. Blum
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA,Corresponding author: Austin W. Blum, JD; Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S. Maryland Avenue, MC 3077, Chicago, IL 60637, USA; Phone: +1 773 834 1325; Fax: +1 773 834 6761;
| | - Brian L. Odlaug
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark,H. Lundbeck A/S, Valby, Denmark
| | - Jon E. Grant
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| |
Collapse
|
15
|
Kertzman SG, Poyurovski M, Faragian S, Weizman R, Cohen K, Aizer A, Weizman A, Dannon PN. Distinct Response Inhibition Patterns in Obsessive Compulsive Disorder Patients and Pathological Gamblers. Front Psychiatry 2018; 9:652. [PMID: 30564153 PMCID: PMC6288432 DOI: 10.3389/fpsyt.2018.00652] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 11/16/2018] [Indexed: 12/11/2022] Open
Abstract
Background: Obsessive-compulsive disorder (OCD) and pathological gambling (PG) are common disorders. The cognitive models of OCD and PG focus on abnormalities in response inhibition. Although, these functions have been studied in different PG and OCD samples, no study has compared the response inhibition in both. Methods: Medication-naïve OCD (n = 61) and PG subjects (n = 109) and healthy controls (n = 131) performed CPT and Go/NoGo tasks. Results: Compared to healthy controls (HC), PG and OCD groups underperformed on speed and exhibited larger time variability on the CPT and Go/NoGo task. Only in OCD patients, a positive correlation between omission errors and response time (RT) was observed in the CPT. At the Go/NoGo task, a negative correlation between false alarms and RT (a fast-errors trade-off) was significant only in the PG group. The HC group had greater sensitivity values (d') than the OCD and PG groups in the Go/NoGo task. The PG group displayed lower d' values and more conservative response criterion in the CPT. In addition, only the OCD group expressed a high switching cost compared to both the PG and HC groups in terms of the RT and d' values. Conclusions: Both the PG and OCD groups demonstrated impaired response inhibition compared to the HC group. On several measures, the OCD and PG groups showed comparable impairments, and in others these were distinct. Thus, it appears that distinct neurocognitive patterns are involved in performance of the CPT and the Go/NoGo tasks among OCD and PG subjects whose cognitive status is currently under intensive investigation.
Collapse
Affiliation(s)
- Semion G Kertzman
- Psychiatry Division, Beer-Yaakov-Ness Ziona Mental Health Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michael Poyurovski
- Tirat Carmel Mental Health Center, Israel University, Tirat Carmel, Israel.,Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
| | - Sarit Faragian
- Tirat Carmel Mental Health Center, Israel University, Tirat Carmel, Israel
| | - Ronit Weizman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Koby Cohen
- Department of Behavioral Science, Ariel University, Ariel, Israel
| | - Anat Aizer
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Abraham Weizman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Research Unit, Geha Mental Health Center and Felsenstein Medical Research Center, Petah Tikva, Israel
| | - Pinhas N Dannon
- Psychiatry Division, Beer-Yaakov-Ness Ziona Mental Health Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
16
|
Kotbagi G, Morvan Y, Romo L, Kern L. Which dimensions of impulsivity are related to problematic practice of physical exercise? J Behav Addict 2017; 6:221-228. [PMID: 28494647 PMCID: PMC5520121 DOI: 10.1556/2006.6.2017.024] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background and aims Problematic practice of physical exercise (PPPE) has been suggested to be a behavioral addiction. Impulsivity represents a core dimension of behavioral addictions. However, little is known about impulsivity facets in PPPE. The aim of this study was to investigate the role of impulsivity facets in PPPE. Methods A total of 684 students (between 18 and 25 years) took part in this study and filled up a battery of questionnaire, which consisted of following measures - Global Physical Activity Questionnaire, Exercise Dependence Scale - Revised, and the UPPS Impulsive Behavior Scale. Multiple regression analyses were utilized to investigate the predictive role of each impulsivity facet in PPPE. Results Age, the total level of physical activity per day, sex (male), negative urgency, and sensation seeking were found to be significant predictors of PPPE. A categorical analysis of PPPE revealed that negative urgency, positive urgency, and sensation seeking were significantly higher in the dependent category of PPPE. Discussion and conclusions Associations to negative urgency and sensation seeking might indicate that PPPE serves to regulate or alleviate negative affect or aversive emotional states. Thus, PPPE could be conceptualized as a short-term coping strategy dedicated to relieving negative affective states, like other maladaptive behaviors such as binge eating, binge drinking, or compulsive buying.
Collapse
Affiliation(s)
- Gayatri Kotbagi
- EA 4430 – CLIPSYD, Université Paris Ouest Nanterre La Défense, Nanterre Cedex, France,Laboratoire EA 2931, Centre de recherches sur le sport et le mouvement – CERSM, Université Paris Ouest Nanterre La Défense, Nanterre Cedex, France,Corresponding author: Gayatri Kotbagi; Université Paris Ouest Nanterre La Défense, 200 Avenue de la République, 92001 Nanterre Cedex, France; Phone: +33 666575871; E-mail:
| | - Yannick Morvan
- EA 4430 – CLIPSYD, Université Paris Ouest Nanterre La Défense, Nanterre Cedex, France
| | - Lucia Romo
- EA 4430 – CLIPSYD, Université Paris Ouest Nanterre La Défense, Nanterre Cedex, France
| | - Laurence Kern
- Laboratoire EA 2931, Centre de recherches sur le sport et le mouvement – CERSM, Université Paris Ouest Nanterre La Défense, Nanterre Cedex, France
| |
Collapse
|
17
|
Wetterneck CT, Burgess AJ, Short MB, Smith AH, Cervantes ME. The Role of Sexual Compulsivity, Impulsivity, and Experiential Avoidance in Internet Pornography Use. PSYCHOLOGICAL RECORD 2017. [DOI: 10.1007/bf03395783] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
18
|
|
19
|
Leppink EW, Redden SA, Chamberlain SR, Grant JE. Cognitive flexibility correlates with gambling severity in young adults. J Psychiatr Res 2016; 81:9-15. [PMID: 27355427 PMCID: PMC5330432 DOI: 10.1016/j.jpsychires.2016.06.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 06/02/2016] [Accepted: 06/10/2016] [Indexed: 01/30/2023]
Abstract
Although gambling disorder (GD) is often characterized as a problem of impulsivity, compulsivity has recently been proposed as a potentially important feature of addictive disorders. The present analysis assessed the neurocognitive and clinical relationship between compulsivity on gambling behavior. A sample of 552 non-treatment seeking gamblers age 18-29 was recruited from the community for a study on gambling in young adults. Gambling severity levels included both casual and disordered gamblers. All participants completed the Intra/Extra-Dimensional Set Shift (IED) task, from which the total adjusted errors were correlated with gambling severity measures, and linear regression modeling was used to assess three error measures from the task. The present analysis found significant positive correlations between problems with cognitive flexibility and gambling severity (reflected by the number of DSM-5 criteria, gambling frequency, amount of money lost in the past year, and gambling urge/behavior severity). IED errors also showed a positive correlation with self-reported compulsive behavior scores. A significant correlation was also found between IED errors and non-planning impulsivity from the BIS. Linear regression models based on total IED errors, extra-dimensional (ED) shift errors, or pre-ED shift errors indicated that these factors accounted for a significant portion of the variance noted in several variables. These findings suggest that cognitive flexibility may be an important consideration in the assessment of gamblers. Results from correlational and linear regression analyses support this possibility, but the exact contributions of both impulsivity and cognitive flexibility remain entangled. Future studies will ideally be able to assess the longitudinal relationships between gambling, compulsivity, and impulsivity, helping to clarify the relative contributions of both impulsive and compulsive features.
Collapse
Affiliation(s)
- Eric W. Leppink
- University of Chicago, Department of Psychiatry & Behavioral
Neuroscience, 5841 S. Maryland Ave., MC3077, Chicago, IL 60637, USA,Corresponding author (E.W.
Leppink)
| | - Sarah A. Redden
- University of Chicago, Department of Psychiatry & Behavioral
Neuroscience, 5841 S. Maryland Ave., MC3077, Chicago, IL 60637, USA
| | - Samuel R. Chamberlain
- Department of Psychiatry, University of Cambridge, Herchel Smith
Building, Robinson Way, Cambridge, CB2 0SZ, UK,Cambridge and Peterborough NHS Foundation Trust (CPFT), Cambridge
Road, Fulbourne, Cambridge, CB21 5HH, UK
| | - Jon E. Grant
- University of Chicago, Department of Psychiatry & Behavioral
Neuroscience, 5841 S. Maryland Ave., MC3077, Chicago, IL 60637, USA
| |
Collapse
|
20
|
Campus P, Maiolati M, Orsini C, Cabib S. Altered consolidation of extinction-like inhibitory learning in genotype-specific dysfunctional coping fostered by chronic stress in mice. Behav Brain Res 2016; 315:23-35. [PMID: 27506654 DOI: 10.1016/j.bbr.2016.08.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Revised: 08/02/2016] [Accepted: 08/06/2016] [Indexed: 01/02/2023]
Abstract
Genetic and stress-related factors interact to foster mental disorders, possibly through dysfunctional learning. In a previous study we reported that a temporary experience of reduced food availability increases forced swim (FS)-induced helplessness tested 14days after a first experience in mice of the standard inbred C57BL/6(B6) strain but reduces it in mice of the genetically unrelated DBA/2J (D2) strain. Because persistence of FS-induced helplessness influences adaptive coping with stress challenge and involve learning processes the present study tested whether the behavioral effects of restricted feeding involved altered consolidation of FS-related learning. First, we demonstrated that restricted feeding does not influence behavior expressed on the first FS experience, supporting a specific effect on persistence rather then development of helplessness. Second, we found that FS-induced c-fos expression in the infralimbic cortex (IL) was selectively enhanced in food-restricted (FR) B6 mice and reduced in FR D2 mice, supporting opposite alterations of consolidation processes involving this brain area. Third, we demonstrated that immediate post-FS inactivation of IL prevents 24h retention of acquired helplessness by continuously free-fed mice of both strains, indicating the requirement of a functioning IL for consolidation of FS-related learning in either mouse strain. Finally, in line with the known role of IL in consolidation of extinction memories, we found that restricted feeding selectively facilitated 24h retention of an acquired extinction in B6 mice whereas impairing it in D2 mice. These findings support the conclusion that an experience of reduced food availability strain-specifically affects persistence of newly acquired passive coping strategies by altering consolidation of extinction-like inhibitory learning.
Collapse
MESH Headings
- Adaptation, Psychological/drug effects
- Adaptation, Psychological/physiology
- Analysis of Variance
- Animals
- Brain/drug effects
- Brain/metabolism
- Conditioning, Operant/drug effects
- Disease Models, Animal
- Escape Reaction/physiology
- Extinction, Psychological/drug effects
- Extinction, Psychological/physiology
- GABA-A Receptor Agonists/pharmacology
- Male
- Mice
- Mice, Inbred C57BL
- Mice, Inbred DBA
- Muscimol/pharmacology
- Proto-Oncogene Proteins c-fos/metabolism
- Species Specificity
- Stress, Psychological/complications
- Stress, Psychological/pathology
- Swimming
Collapse
Affiliation(s)
- P Campus
- Department of Psychology, Center D. Bovet, Sapienza University of Rome, Rome, Italy; Fondazione Santa Lucia, IRCCS, Rome, Italy
| | - M Maiolati
- Department of Psychology, Center D. Bovet, Sapienza University of Rome, Rome, Italy
| | - C Orsini
- Department of Psychology, Center D. Bovet, Sapienza University of Rome, Rome, Italy; Fondazione Santa Lucia, IRCCS, Rome, Italy
| | - S Cabib
- Department of Psychology, Center D. Bovet, Sapienza University of Rome, Rome, Italy; Fondazione Santa Lucia, IRCCS, Rome, Italy.
| |
Collapse
|
21
|
Northey L, Dunkley CR, Klonsky ED, Gorzalka BB. Borderline personality disorder traits and sexuality: Bridging a gap in the literature. THE CANADIAN JOURNAL OF HUMAN SEXUALITY 2016. [DOI: 10.3138/cjhs.252-a8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Extant research connecting borderline personality disorder (BPD) to sexuality is sparse. The current study aimed to expand the limited body of research on borderline personality traits and human sexuality, and to shed light on the personality features that contribute specifically to sexual sensation seeking, sexual compulsivity, and sexual risk-taking behaviours. Undergraduate students (n=955) completed an online questionnaire containing scales assessing BPD symptoms (affective instability, identity disturbance, negative relationships, and self-harm), sexual sensation seeking, sexual compulsivity, and sexual risk-taking. Multiple linear regression analyses were conducted and revealed no significant gender X symptom interaction predictors. Results did indicate links between specific BPD symptoms and specific sexuality variables. Total sexual compulsivity and compulsive sexual control behaviours were positively predicted by all four BPD symptoms, whereas compulsive sexual violence was predicted by all symptoms except for identity disturbance. Sexual sensation seeking was positively predicted by negative relationships and self-harm. Sexual risk taking was not significantly predicted by any BPD symptoms. These findings improve our understanding of how individuals with borderline personality traits experience romantic and sexual relationships, and may inform the future development of therapeutic interventions.
Collapse
Affiliation(s)
- Lynnaea Northey
- Department of Psychology, Simon Fraser University, Burnaby, BC
| | - Cara R. Dunkley
- Department of Psychology, University of British Columbia, Vancouver, BC
| | - E. David Klonsky
- Department of Psychology, University of British Columbia, Vancouver, BC
| | - Boris B. Gorzalka
- Department of Psychology, University of British Columbia, Vancouver, BC
| |
Collapse
|
22
|
Chamberlain SR, Leppink EW, Redden SA, Grant JE. Are obsessive-compulsive symptoms impulsive, compulsive or both? Compr Psychiatry 2016; 68:111-8. [PMID: 27234191 PMCID: PMC5330431 DOI: 10.1016/j.comppsych.2016.04.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Revised: 03/26/2016] [Accepted: 04/11/2016] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND The relationships between obsessive-compulsive symptoms and distinct forms of impulsivity and compulsivity are unclear. Such examination would be relevant in terms of how best to classify psychiatric disorders and in understanding candidate 'traits' that extend across a continuum between normalcy and clinical disorders. METHOD 515 young adults (aged 18-29years) completed the Padua Inventory and undertook detailed clinical and neurocognitive assessments. Relationships between obsessive-compulsive symptoms and distinct types of impulsivity and compulsivity were evaluated using linear regression modeling. RESULTS Obsessive-Compulsive symptoms were significantly predicted by female gender, lower quality of life, psychiatric disorders in general (but not impulse control disorders), and worse extra-dimensional set-shifting. Obsessive-Compulsive symptoms were not significantly predicted by alcohol/nicotine consumption, stop-signal reaction times, or decision-making abilities. CONCLUSION These data indicate that obsessive-compulsive symptoms are more related to certain forms of compulsivity than to impulsivity. These findings have important implications for diagnostic conceptualizations and neurobiological models.
Collapse
Affiliation(s)
- Samuel R Chamberlain
- Department of Psychiatry, University of Cambridge, UK,Cambridge and Peterborough NHS Foundation Trust, UK
| | - Eric W. Leppink
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago
| | - Sarah A. Redden
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago
| | - Jon E. Grant
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago
| |
Collapse
|
23
|
Bottesi G, Ghisi M, Ouimet AJ, Tira MD, Sanavio E. Compulsivity and Impulsivity in Pathological Gambling: Does a Dimensional-Transdiagnostic Approach Add Clinical Utility to DSM-5 Classification? J Gambl Stud 2016; 31:825-47. [PMID: 24863627 DOI: 10.1007/s10899-014-9470-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Although the phenomenology of Pathological Gambling (PG) is clearly characterized by impulsive features, some of the Diagnostic and Statistical Manual of Mental Disorder (DSM-5) criteria for PG are similar to those of Obsessive Compulsive Disorder (OCD). Therefore, the compulsive-impulsive spectrum model may be a better (or complementary) fit with PG phenomenology. The present exploratory research was designed to further investigate the compulsive and impulsive features characterizing PG, by comparing PG individuals, alcohol dependents (ADs), OCD patients, and healthy controls (HCs) on both self-report and cognitive measures of compulsivity and impulsivity. A better understanding of the shared psychological and cognitive mechanisms underlying differently categorized compulsive and impulsive disorders may significantly impact on both clinical assessment and treatment strategies for PG patients. With respect to self-report measures, PG individuals reported more compulsive and impulsive features than did HCs. As regards motor inhibition ability indices, PG individuals and HCs performed similarly on the Go/No-go task and better than AD individuals and OCD patients. Results from the Iowa Gambling Task highlighted that PG, AD, and OCD participants performed worse than did HCs. An in-depth analysis of each group's learning profile revealed similar patterns of impairment between PG and AD individuals in decision-making processes. Current findings support the utility of adopting a dimensional-transdiagnostic approach to complement the DSM-5 classification when working with PG individuals in clinical practice. Indeed, clinicians are encouraged to assess both compulsivity and impulsivity to provide individualized case conceptualizations and treatment plans focusing on the specific phenomenological features characterizing each PG patient.
Collapse
Affiliation(s)
- Gioia Bottesi
- Department of General Psychology, University of Padova, Via Venezia, 8, 35131, Padua, Italy,
| | | | | | | | | |
Collapse
|
24
|
Grant JE, Odlaug BL, Chamberlain SR. Neural and psychological underpinnings of gambling disorder: A review. Prog Neuropsychopharmacol Biol Psychiatry 2016; 65:188-93. [PMID: 26497079 DOI: 10.1016/j.pnpbp.2015.10.007] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 10/17/2015] [Accepted: 10/20/2015] [Indexed: 01/14/2023]
Abstract
Gambling disorder affects 0.4 to 1.6% of adults worldwide, and is highly comorbid with other mental health disorders. This article provides a concise primer on the neural and psychological underpinnings of gambling disorder based on a selective review of the literature. Gambling disorder is associated with dysfunction across multiple cognitive domains which can be considered in terms of impulsivity and compulsivity. Neuroimaging data suggest structural and functional abnormalities of networks involved in reward processing and top-down control. Gambling disorder shows 50-60% heritability and it is likely that various neurochemical systems are implicated in the pathophysiology (including dopaminergic, glutamatergic, serotonergic, noradrenergic, and opioidergic). Elevated rates of certain personality traits (e.g. negative urgency, disinhibition), and personality disorders, are found. More research is required to evaluate whether cognitive dysfunction and personality aspects influence the longitudinal course and treatment outcome for gambling disorder. It is hoped that improved understanding of the biological and psychological components of gambling disorder, and their interactions, may lead to improved treatment approaches and raise the profile of this neglected condition.
Collapse
Affiliation(s)
- Jon E Grant
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, IL, USA.
| | - Brian L Odlaug
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Samuel R Chamberlain
- Department of Psychiatry, University of UK, & Cambridge and Peterborough NHS Foundation Trust, United Kingdom
| |
Collapse
|
25
|
Turton R, Bruidegom K, Cardi V, Hirsch CR, Treasure J. Novel methods to help develop healthier eating habits for eating and weight disorders: A systematic review and meta-analysis. Neurosci Biobehav Rev 2016; 61:132-55. [DOI: 10.1016/j.neubiorev.2015.12.008] [Citation(s) in RCA: 124] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 11/12/2015] [Accepted: 12/10/2015] [Indexed: 12/21/2022]
|
26
|
Pal A, Parmar A, Pattanayak RD. Repetitive urges to inflict burns: An unusual presentation of impulse control disorder. Ind Psychiatry J 2016; 25:113-115. [PMID: 28163418 PMCID: PMC5248411 DOI: 10.4103/0972-6748.196042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Impulse control disorders (ICDs) are characterized by an inability to resist an intense impulse or drive to perform a particular act that is excessive and/or harmful to self/others. Till date, there is no published report of an ICD presenting with repetitive urges to inflict burns. We describe the case of an adult male in regular follow-up for 6 months who presented with intense, irresistible, and repetitive urges and acts of causing burns on his skin for past 1 year. The phenomenology shared the core qualities described for ICDs and patient showed adequate response to treatment. The case report describes an unusual type of ICD classifiable as not otherwise specified. More clinical and research attention is warranted toward ICDs in general, with implications for ICD-11.
Collapse
Affiliation(s)
- Arghya Pal
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Arpit Parmar
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | | |
Collapse
|
27
|
Kingston DA. Hypersexuality Disorders and Sexual Offending. SEXUAL OFFENDING 2016. [DOI: 10.1007/978-1-4939-2416-5_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
|
28
|
Effects of gender and executive function on visuospatial working memory in adult obsessive-compulsive disorder. Eur Arch Psychiatry Clin Neurosci 2015; 265:707-18. [PMID: 25972085 DOI: 10.1007/s00406-015-0604-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 05/06/2015] [Indexed: 10/23/2022]
Abstract
Visuospatial working memory (VSWM) is the ability of the brain to transiently store and manipulate visual information. VSWM deficiencies have been reported in obsessive-compulsive disorder (OCD), but not consistently, perhaps due to variability in task design and clinical patient factors. To explore this variability, this study assessed effects of the design factors task difficulty and executive organizational strategy and of the clinical factors gender, OCD symptom dimension, and duration of illness on VSWM in OCD. The CANTAB spatial working memory, spatial recognition memory, delayed matching to sample, and stop signal tasks were administered to 42 adult OCD patients and 42 age- and sex-matched healthy controls. Aims were to detect a possible VSWM deficit in the OCD sample, to evaluate influences of the above task and patient factors, to determine the specificity of the deficit to the visuospatial subdomain, and to examine effects of sustained attention as potential neurocognitive confound. We confirmed previous findings of a VSWM deficit in OCD that was more severe for greater memory load (task difficulty) and that was affected by task strategy (executive function). We failed to demonstrate significant deficits in neighboring or confounding neurocognitive subdomains (visual object recognition or visual object short-term memory, sustained attention). Notably, the VSWM deficit was only significant for female patients, adding to evidence for sexual dimorphism in OCD. Again as in prior work, more severe OCD symptoms in the symmetry dimension (but no other dimension) significantly negatively impacted VSWM. Duration of illness had no significant effect on VSWM. VSWM deficits in OCD appear more severe with higher task load and may be mediated through poor task strategy. Such deficits may present mainly in female patients and in (male and female) patients with symmetry symptoms.
Collapse
|
29
|
|
30
|
Naaijen J, Lythgoe DJ, Amiri H, Buitelaar JK, Glennon JC. Fronto-striatal glutamatergic compounds in compulsive and impulsive syndromes: A review of magnetic resonance spectroscopy studies. Neurosci Biobehav Rev 2015; 52:74-88. [DOI: 10.1016/j.neubiorev.2015.02.009] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2014] [Revised: 12/20/2014] [Accepted: 02/13/2015] [Indexed: 11/29/2022]
|
31
|
|
32
|
Jiménez-Murcia S, Granero R, Moragas L, Steiger H, Israel M, Aymamí N, Gómez-Peña M, Sauchelli S, Agüera Z, Sánchez I, Riesco N, Penelo E, Menchón JM, Fernández-Aranda F. Differences and Similarities Between Bulimia Nervosa, Compulsive Buying and Gambling Disorder. EUROPEAN EATING DISORDERS REVIEW 2014; 23:111-8. [DOI: 10.1002/erv.2340] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 11/21/2014] [Accepted: 11/24/2014] [Indexed: 12/22/2022]
Affiliation(s)
- Susana Jiménez-Murcia
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
- Ciber Fisiopatología de la Obesidad y Nutrición (CIBEROBN); Instituto de Salud Carlos III; Madrid Spain
| | - Roser Granero
- Ciber Fisiopatología de la Obesidad y Nutrición (CIBEROBN); Instituto de Salud Carlos III; Madrid Spain
- Departament de Psicobiologia i Metodologia de les Ciències de la Salut; Universitat Autònoma de Barcelona; Barcelona Spain
| | - Laura Moragas
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
| | - Howard Steiger
- Douglas Mental Health University Institute; Montreal Canada
| | - Mimi Israel
- Douglas Mental Health University Institute; Montreal Canada
| | - Neus Aymamí
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
| | - Mónica Gómez-Peña
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
| | - Sarah Sauchelli
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
| | - Zaida Agüera
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
| | - Isabel Sánchez
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
| | - Nadine Riesco
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
| | - Eva Penelo
- Departament de Psicobiologia i Metodologia de les Ciències de la Salut; Universitat Autònoma de Barcelona; Barcelona Spain
| | - José M. Menchón
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
- Ciber de Salud Mental (CIBERSAM); Instituto Salud Carlos III; Madrid Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
- Ciber Fisiopatología de la Obesidad y Nutrición (CIBEROBN); Instituto de Salud Carlos III; Madrid Spain
| |
Collapse
|
33
|
Sohn SY, Kang JI, Namkoong K, Kim SJ. Multidimensional measures of impulsivity in obsessive-compulsive disorder: cannot wait and stop. PLoS One 2014; 9:e111739. [PMID: 25372136 PMCID: PMC4221112 DOI: 10.1371/journal.pone.0111739] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 10/06/2014] [Indexed: 11/18/2022] Open
Abstract
Objective Although the relationship between obsessive compulsive disorder (OCD) and impulsivity has long been debated, impulsivity has not been systematically examined in clinical samples of OCD. Meanwhile, recent findings suggest that impulsivity is multi-dimensional construct that can be examined through several constructs. Therefore, this study is aimed to evaluate multiple facets of impulsivity in OCD. Method The recruitment includes 80 OCD and 76 healthy control participants. Participants completed a test battery comprising three behavioral tasks of stop signal task (SST), delay discounting task (DDT) and balloon analog risk test (BART), and one self-report measure of the Barratt Impulsiveness scale (BIS-11). Results OCD subjects showed significantly lower stop signal reaction time of SST reflecting higher action impulsivity and higher delay discounting parameter of DDT suggesting increased choice impulsivity but significantly lower adjusted mean pump of BART implying lower risk taking propensity of BART than healthy control. Conclusion Increased Action and choice impulsivity, and decreased risk taking propensities were found in OCD. These findings seem to be consistent with clinical characteristics of OCD such as greater preference for or avoid risky situations (avoidance), inability to wait tension relief may provoke safety behaviors (compulsion) and inability to stop already started behaviors (repetition).
Collapse
Affiliation(s)
- Sung Yun Sohn
- Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jee In Kang
- Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Kee Namkoong
- Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Se Joo Kim
- Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
- * E-mail:
| |
Collapse
|
34
|
Ansquer S, Belin-Rauscent A, Dugast E, Duran T, Benatru I, Mar AC, Houeto JL, Belin D. Atomoxetine decreases vulnerability to develop compulsivity in high impulsive rats. Biol Psychiatry 2014; 75:825-32. [PMID: 24252357 DOI: 10.1016/j.biopsych.2013.09.031] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 09/19/2013] [Accepted: 09/21/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND The factors contributing to the development and severity of obsessive-compulsive spectrum disorders such as obsessive-compulsive disorder, Tourette's syndrome, pathological gambling, and addictions remain poorly understood, limiting the development of therapeutic and preventive strategies. Recent evidence indicates that impulse-control deficits may contribute to the severity of compulsivity in several of these disorders. This suggests that impulsivity may be a transnosological endophenotype of vulnerability to compulsivity. However, the precise nature of the link between impulsivity and compulsivity in anxiety-related compulsive disorders remains unknown. METHODS We investigated the relationship between impulsivity and the development of a compulsive behavior in rats, which captures the hallmarks of compulsivity as defined in the DSM-IV--namely, that it is maladaptive, excessive, repetitive, and anxiolytic. RESULTS We demonstrate that a high-impulsivity trait, as measured in the five-choice serial reaction time task, predicts an increased propensity to develop compulsivity as measured in a schedule-induced polydipsia procedure. Trait impulsivity and compulsivity were nonlinearly related. This impulsivity-compulsivity relationship was lost after the development of compulsivity or under chronic treatment with atomoxetine, a noradrenergic reuptake inhibitor used to treat attention-deficit/hyperactivity disorder. Atomoxetine treatment both decreased impulsivity and prevented the development of compulsivity in high-impulsive animals. CONCLUSIONS These observations provide insight into the reciprocal influence of impulsivity and compulsivity in compulsive disorders and suggest that atomoxetine may be a useful treatment for patients suffering from obsessive-compulsive spectrum disorders with high impulsivity.
Collapse
Affiliation(s)
- Solène Ansquer
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1084-LNEC Experimental and Clinical Neurosciences Laboratory, Poitiers, France; Team Psychobiology of Compulsive Disorders, University of Poitiers, Poitiers, France; Service de Neurologie de l'Hôpital de Poitiers, Poitiers, France
| | - Aude Belin-Rauscent
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1084-LNEC Experimental and Clinical Neurosciences Laboratory, Poitiers, France; Team Psychobiology of Compulsive Disorders, University of Poitiers, Poitiers, France; INSERM European Associated Laboratory Psychobiology of Compulsive Habits, Cambridge, United Kingdom; INSERM CIC-0802, Poitiers, France
| | - Emilie Dugast
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1084-LNEC Experimental and Clinical Neurosciences Laboratory, Poitiers, France; Team Psychobiology of Compulsive Disorders, University of Poitiers, Poitiers, France; INSERM European Associated Laboratory Psychobiology of Compulsive Habits, Cambridge, United Kingdom
| | - Théo Duran
- Department of Psychology, Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom; Department of Pharmacology, University of Cambridge, Cambridge, United Kingdom
| | - Isabelle Benatru
- Service de Neurologie de l'Hôpital de Poitiers, Poitiers, France; CNRS GDR 3557 "Institut de Psychiatrie", Poitiers, France
| | - Adam C Mar
- Hôpital Sainte Anne, Paris, France; Institut des Neurosciences de Grenoble-CR Inserm U.836; Université Joseph Fourier-Site Santé La Tronche-CHU Grenoble, Grenoble, France
| | - Jean-Luc Houeto
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1084-LNEC Experimental and Clinical Neurosciences Laboratory, Poitiers, France; Team Psychobiology of Compulsive Disorders, University of Poitiers, Poitiers, France; INSERM European Associated Laboratory Psychobiology of Compulsive Habits, Cambridge, United Kingdom; CNRS GDR 3557 "Institut de Psychiatrie", Poitiers, France
| | - David Belin
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1084-LNEC Experimental and Clinical Neurosciences Laboratory, Poitiers, France; Team Psychobiology of Compulsive Disorders, University of Poitiers, Poitiers, France; INSERM European Associated Laboratory Psychobiology of Compulsive Habits, Cambridge, United Kingdom; INSERM CIC-0802, Poitiers, France.
| |
Collapse
|
35
|
Abstract
Impulsivity and compulsivity have been considered opposite poles of a continuous spectrum, but their relationship appears to be more complex. Disorders characterized by impulsivity often have features of compulsivity and vice versa. The overlaps of the constructs of compulsivity and impulsivity warrant additional investigation, not only to identify the similarities and differences, but also to examine the implications for prevention and treatment strategies of both compulsive and impulsive behaviors.
Collapse
|
36
|
Rosenberg KP, Carnes P, O'Connor S. Evaluation and treatment of sex addiction. JOURNAL OF SEX & MARITAL THERAPY 2013; 40:77-91. [PMID: 23790248 DOI: 10.1080/0092623x.2012.701268] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
There have been several diagnostic labels for persistent, excessive sexual behaviors, often referred in the popular media as sex addiction. Two related diagnoses, Internet addictive disorder and hypersexual disorder, were considered for, but not included in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders. However, most clinicians, even those trained in sexual disorders or addiction medicine, have little to no training in treating sexual compulsivity and cybersex addiction. The authors present the historical context, proposed diagnostic criteria, evaluation protocols, comorbid disorders, speculations about the neuroscience, and treatment recommendations.
Collapse
MESH Headings
- Adult
- Behavior, Addictive/diagnosis
- Behavior, Addictive/physiopathology
- Behavior, Addictive/psychology
- Behavior, Addictive/therapy
- Brain/physiopathology
- Comorbidity
- Diagnosis, Differential
- Disruptive, Impulse Control, and Conduct Disorders/diagnosis
- Disruptive, Impulse Control, and Conduct Disorders/physiopathology
- Disruptive, Impulse Control, and Conduct Disorders/psychology
- Disruptive, Impulse Control, and Conduct Disorders/therapy
- Humans
- Internet
- Male
- Motivation/physiology
- Nerve Net/physiology
- Object Attachment
- Obsessive-Compulsive Disorder/diagnosis
- Obsessive-Compulsive Disorder/physiopathology
- Obsessive-Compulsive Disorder/psychology
- Obsessive-Compulsive Disorder/therapy
- Psychometrics/statistics & numerical data
- Reproducibility of Results
- Sexual Behavior/psychology
- Surveys and Questionnaires
- Treatment Outcome
Collapse
|
37
|
Flessner CA, Knopik VS, McGeary J. Hair pulling disorder (trichotillomania): genes, neurobiology, and a model for understanding impulsivity and compulsivity. Psychiatry Res 2012; 199:151-8. [PMID: 22537722 DOI: 10.1016/j.psychres.2012.03.039] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2011] [Revised: 10/06/2011] [Accepted: 03/13/2012] [Indexed: 01/23/2023]
Abstract
Hair pulling disorder (trichotillomania) affects at least 3.7 million people in the United States and results in marked functional impairment. This article reviews empirical research investigating the genetics and neurobiology of hair pulling disorder (HPD). We also discuss recent advances in the characterization of this phenotype which have led to evidence supporting the existence of at least two disparate pulling styles-automatic and focused pulling. These pulling styles exhibit facets of behavioral processes, impulsivity and compulsivity, characteristic of several classes of disorders (e.g., obsessive-compulsive spectrum disorders, impulse control disorders). Available genetic, neurobiological, and clinical data support the importance of impulsivity for conceptualizing HPD. Impulsivity alone is insufficient to fully understand this complex phenotype. Characterizations of both automatic and focused pulling as well as preliminary findings from affective neuroscience across species highlight the importance of compulsivity for understanding HPD. Opposing and complementary aspects to impulsivity-compulsivity provide a more comprehensive conceptualization of HPD and supports HPD's potential importance for advancing scientific inquiry in relation to the pathogenesis and treatment of related phenotypes. This review concludes with a description of areas-phenotype, neurobiology, and genes-in need of further study.
Collapse
|
38
|
Kashyap H, Fontenelle LF, Miguel EC, Ferrão YA, Torres AR, Shavitt RG, Ferreira-Garcia R, do Rosário MC, Yücel M. 'Impulsive compulsivity' in obsessive-compulsive disorder: a phenotypic marker of patients with poor clinical outcome. J Psychiatr Res 2012; 46:1146-52. [PMID: 22647523 DOI: 10.1016/j.jpsychires.2012.04.022] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Revised: 03/31/2012] [Accepted: 04/26/2012] [Indexed: 10/28/2022]
Abstract
Although traditionally obsessive-compulsive disorder (OCD) and impulse control disorders (ICD) have represented opposing ends of a continuum, recent research has demonstrated a frequent co-occurrence of impulsive and compulsive behaviours, which may contribute to a worse clinical picture of some psychiatric disorders. We hypothesize that individuals with 'impulsive' OCD as characterized by poor insight, low resistance, and reduced control towards their compulsions will have a deteriorative course, greater severity of hoarding and/or symmetry/ordering symptoms, and comorbid ICD and/or substance use disorders (SUD). The sample consisted of 869 individuals with a minimum score of 16 on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Of these, 65 had poor insight, low resistance, and reduced control towards compulsions ('poor IRC') and 444 had preserved insight, greater resistance and better control over compulsions ('good IRC'). These two groups were compared on a number of clinical and demographic variables. Individuals with poor IRC were significantly more likely to have a deteriorative course (p < 0.001), longer duration of obsessions (p = 0.017), greater severity of symmetry/ordering (p < 0.001), contamination/cleaning (p < 0.001) and hoarding (p = 0.002) symptoms, and comorbid intermittent explosive disorder (p = 0.026), trichotillomania (p = 0.014) and compulsive buying (p = 0.040). Regression analysis revealed that duration of obsessions (p = 0.037) and hoarding severity (p = 0.005) were significant predictors of poor IRC. In the absence of specific measures for impulsivity in OCD, the study highlights the utility of simple measures such as insight, resistance and control over compulsions as a phenotypic marker of a subgroup of OCD with impulsive features demonstrating poor clinical outcome.
Collapse
Affiliation(s)
- Himani Kashyap
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Australia
| | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Tiago S, Nuno M, João A, Carla V, Gonçalo M, Joana N. Trichophagia and trichobezoar: case report. Clin Pract Epidemiol Ment Health 2012; 8:43-5. [PMID: 22675398 PMCID: PMC3367296 DOI: 10.2174/1745017901208010043] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2011] [Revised: 02/05/2012] [Accepted: 02/05/2012] [Indexed: 12/23/2022]
Abstract
Objective: Trichobezoar consists of a compact mass of hair occupying the gastric cavity to a various extent. When the trichobezoar extends past the duodenum it is better referred to as Rapunzel Syndrome. Although trichobezoars are well described in terms of surgical diagnostic and procedure, there are only but very scarce reports on psychiatric literature, usually associated with trichotillomania. The authors present a clinical case of trichobezoar and discuss the most relevant aspects concerning this entity. Methods: Presentation of psychiatric and surgical data concerning the case report. Previously reported cases are also mentioned. Results: Report of a 27-year-old female patient with a trichobezoar submitted to surgical removal, with a prior intervention 4 years before also due to trichobezoar, and with unknown psychiatric antecedents or follow-up. Conclusions: A trichobezoar represents a serious surgical condition. It is important to consider such diagnosis in face of suggestive symptoms, even if signs of trichotillomania are not present. The discrepancies between the prevalence of trichotillomania and trichobezoars due to trichophagia may be due to issues related to self-selection of patients and symptom severity. Such issues may also be important in the study of impulsive-compulsive spectrum models and to their relevance to impulse control disorders.
Collapse
Affiliation(s)
- Santos Tiago
- Department of Psychiatry and Mental Health, Hospital Infante D. Pedro, Aveiro, Portugal
| | | | | | | | | | | |
Collapse
|
40
|
Muresanu DF, Stan A, Buzoianu A. Neuroplasticity and impulse control disorders. J Neurol Sci 2012; 316:15-20. [PMID: 22336702 DOI: 10.1016/j.jns.2012.01.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2011] [Revised: 01/11/2012] [Accepted: 01/20/2012] [Indexed: 11/25/2022]
Abstract
Impulse control disorders (ICDs) represent an important medical challenge. The authors of the present paper restricted themselves to present an overview of the neurocircuitry that is involved in ICDs and to present information about the mechanisms of neuroplasticity that are the substrate of the ICDs. Understanding the networks involved in ICDs at the level of the cellular and molecular mechanisms of neural and synaptic plasticity may facilitate the understanding of the ways in which various conditions favour the habit formation and compulsivity that are associated with neurological disorders. The psychological, sociological and forensic dimensions of ICDs are beyond the scope of this paper.
Collapse
Affiliation(s)
- Dafin F Muresanu
- University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania.
| | | | | |
Collapse
|
41
|
Angoa-Pérez M, Kane MJ, Briggs DI, Sykes CE, Shah MM, Francescutti DM, Rosenberg DR, Thomas DM, Kuhn DM. Genetic depletion of brain 5HT reveals a common molecular pathway mediating compulsivity and impulsivity. J Neurochem 2012; 121:974-84. [PMID: 22443164 DOI: 10.1111/j.1471-4159.2012.07739.x] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Neuropsychiatric disorders characterized by behavioral disinhibition, including disorders of compulsivity (e.g. obsessive-compulsive disorder; OCD) and impulse-control (e.g. impulsive aggression), are severe, highly prevalent and chronically disabling. Treatment options for these diseases are extremely limited. The pathophysiological bases of disorders of behavioral disinhibition are poorly understood but it has been suggested that serotonin dysfunction may play a role. Mice lacking the gene encoding brain tryptophan hydroxylase 2 (Tph2-/-), the initial and rate-limiting enzyme in the synthesis of serotonin, were tested in numerous behavioral assays that are well known for their utility in modeling human neuropsychiatric diseases. Mice lacking Tph2 (and brain 5HT) show intense compulsive and impulsive behaviors to include extreme aggression. The impulsivity is motor in form and not cognitive because Tph2-/- mice show normal acquisition and reversal learning on a spatial learning task. Restoration of 5HT levels by treatment of Tph2-/- mice with its immediate precursor 5-hydroxytryptophan attenuated compulsive and impulsive-aggressive behaviors. Surprisingly, in Tph2-/- mice, the lack of 5HT was not associated with anxiety-like behaviors. The results indicate that 5HT mediates behavioral disinhibition in the mammalian brain independent of anxiogenesis.
Collapse
Affiliation(s)
- Mariana Angoa-Pérez
- Department of Psychiatry & Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Freimuth M, Moniz S, Kim SR. Clarifying exercise addiction: differential diagnosis, co-occurring disorders, and phases of addiction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2011; 8:4069-81. [PMID: 22073029 PMCID: PMC3210598 DOI: 10.3390/ijerph8104069] [Citation(s) in RCA: 110] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Revised: 10/08/2011] [Accepted: 10/17/2011] [Indexed: 11/16/2022]
Abstract
This paper sets out to clarify the unique features of exercise addiction. It begins by examining how this addiction can be distinguished from compulsions and impulse control disorders both of which, like an addiction, involve excessive behavior that creates adverse effects. Assessment of exercise addiction also requires that clinicians be attuned to other forms of excessive behavior, especially eating disorders that can co-occur with exercise. Finally in an effort to clarify exercise addiction, this paper uses the four phases of addiction to examine the attributes of exercise that define it as a healthy habit distinct from an addiction. The paper ends with a discussion of the implications of these topics for effective assessment and treatment.
Collapse
MESH Headings
- Behavior, Addictive/classification
- Behavior, Addictive/diagnosis
- Behavior, Addictive/epidemiology
- Behavior, Addictive/therapy
- Comorbidity
- Compulsive Behavior/classification
- Compulsive Behavior/diagnosis
- Compulsive Behavior/epidemiology
- Diagnosis, Differential
- Disruptive, Impulse Control, and Conduct Disorders/classification
- Disruptive, Impulse Control, and Conduct Disorders/diagnosis
- Disruptive, Impulse Control, and Conduct Disorders/epidemiology
- Exercise/psychology
- Feeding and Eating Disorders/classification
- Feeding and Eating Disorders/diagnosis
- Feeding and Eating Disorders/epidemiology
- Humans
- Substance-Related Disorders/classification
- Substance-Related Disorders/diagnosis
- Substance-Related Disorders/epidemiology
Collapse
Affiliation(s)
- Marilyn Freimuth
- School of Psychology, Fielding Graduate University, Santa Barbara, CA 93105, USA.
| | | | | |
Collapse
|
43
|
Development and validation of the appearance and performance enhancing drug use schedule. Addict Behav 2011; 36:949-58. [PMID: 21640487 DOI: 10.1016/j.addbeh.2011.05.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2010] [Revised: 05/04/2011] [Accepted: 05/05/2011] [Indexed: 11/22/2022]
Abstract
Appearance-and-performance enhancing drug (APED) use is a form of drug use that includes use of a wide range of substances such as anabolic-androgenic steroids (AASs) and associated behaviors including intense exercise and dietary control. To date, there are no reliable or valid measures of the core features of APED use. The present study describes the development and psychometric evaluation of the Appearance and Performance Enhancing Drug Use Schedule (APEDUS) which is a semi-structured interview designed to assess the spectrum of drug use and related features of APED use. Eighty-five current APED using men and women (having used an illicit APED in the past year and planning to use an illicit APED in the future) completed the APEDUS and measures of convergent and divergent validity. Inter-rater agreement, scale reliability, one-week test-retest reliability, convergent and divergent validity, and construct validity were evaluated for each of the APEDUS scales. The APEDUS is a modular interview with 10 sections designed to assess the core drug and non-drug phenomena associated with APED use. All scales and individual items demonstrated high inter-rater agreement and reliability. Individual scales significantly correlated with convergent measures (DSM-IV diagnoses, aggression, impulsivity, eating disorder pathology) and were uncorrelated with a measure of social desirability. APEDUS subscale scores were also accurate measures of AAS dependence. The APEDUS is a reliable and valid measure of APED phenomena and an accurate measure of the core pathology associated with APED use. Issues with assessing APED use are considered and future research is considered.
Collapse
|
44
|
Barros SM, de Carvalho JF. Pathological gambling and primary antiphospholipid (Hughes) syndrome: a unique neuropsychiatric association. Lupus 2011; 20:1086-1089. [DOI: 10.1177/0961203310397564] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
Neuropsychiatric conditions are common in patients with primary antiphospholipid syndrome (APS) with or without vascular thrombosis of the central nervous system. There are frequent descriptions of memory alterations, cognition and mood disorders, such as depression, anxiety, and even conditions of mania and psychosis preceding the diagnosis of primary APS. However, this study is the first to present primary or secondary APS associated with habit or impulse control disorders. The authors describe the case of a 53-year-old male patient who had been a pathological gambler since adulthood and who has had APS for more than 20 years. We describe the case and review its characteristics, criteria for diagnosis and treatment offered for patients with this specific subtype of impulse disorder.
Collapse
Affiliation(s)
- SM Barros
- Department of Rheumatology, Naval Hospital Marcílio Dias, Rio de Janeiro, RJ, Brazil
| | - JF de Carvalho
- Department of Rheumatology, Clinical Hospital, College of Medicine, Universidade de São Paulo, São Paulo, Brazil
| |
Collapse
|
45
|
Impulsivity, Emotion Regulation, and Mindful Attentional Focus in Compulsive Buying. COGNITIVE THERAPY AND RESEARCH 2011. [DOI: 10.1007/s10608-011-9384-9] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
46
|
Abosch A, Gupte A, Eberly LE, Tuite PJ, Nance M, Grant JE. Impulsive behavior and associated clinical variables in Parkinson's disease. PSYCHOSOMATICS 2011; 52:41-7. [PMID: 21300194 DOI: 10.1016/j.psym.2010.11.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2009] [Revised: 11/30/2009] [Accepted: 12/03/2009] [Indexed: 11/28/2022]
Abstract
BACKGROUND Parkinson's disease (PD) is a degenerative brain disorder accompanied by the loss of dopaminergic neurons and the presence of motor and non-motor symptoms. OBJECTIVE We performed a cross-sectional, questionnaire-based analysis of impulsive behavior in our PD clinic population to assess prevalence and associated characteristics. RESULTS We found a higher prevalence of impulsive behavior (29.7%) than previously reported, and found multiple, concurrent impulsive behaviors in 26% of subjects reporting impulsive behavior. CONCLUSIONS Our findings contribute to the growing awareness of impulsive behavior in PD, and support the need for longitudinal studies to assess changes in impulsive behaviors in Parkinson's patients.
Collapse
Affiliation(s)
- Aviva Abosch
- Department of Neurosurgery, University of Minnesota Medical School, Minneapolis, MN 55455, USA.
| | | | | | | | | | | |
Collapse
|
47
|
Grant JE, Chamberlain SR, Odlaug BL, Potenza MN, Kim SW. Memantine shows promise in reducing gambling severity and cognitive inflexibility in pathological gambling: a pilot study. Psychopharmacology (Berl) 2010; 212:603-12. [PMID: 20721537 PMCID: PMC3465841 DOI: 10.1007/s00213-010-1994-5] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2010] [Accepted: 08/02/2010] [Indexed: 10/19/2022]
Abstract
RATIONALE Although pathological gambling (PG) is relatively common, pharmacotherapy research for PG is limited. Memantine, an N-methyl D-aspartate receptor antagonist, appears to reduce glutamate excitability and improve impulsive decision making, suggesting it may help individuals with PG. OBJECTIVE This study sought to examine the safety and efficacy of Memantine in PG. METHODS Twenty-nine subjects (18 females) with DSM-IV PG were enrolled in a 10-week open-label treatment study of memantine (dose ranging from 10 to 30 mg/day). Subjects were enrolled from January 2009 until April 2010. Change from baseline to study endpoint on the Yale Brown Obsessive Compulsive Scale Modified for Pathological Gambling (PG-YBOCS) was the primary outcome measure. Subjects underwent pre- and post-treatment cognitive assessments using the stop-signal task (assessing response impulsivity) and the intra-dimensional/extra-dimensional (ID/ED) set shift task (assessing cognitive flexibility). RESULTS Twenty-eight of the 29 subjects (96.6%) completed the 10-week study. PG-YBOCS scores decreased from a mean of 21.8 ± 4.3 at baseline to 8.9 ± 7.1 at study endpoint (p < 0.001). Hours spent gambling per week and money spent gambling both decreased significantly (p < 0.001). Subjects also demonstrated a significant improvement in ID/ED total errors (p = 0.037) at study endpoint. The mean effective dose of memantine was 23.4 ± 8.1 mg/day. The medication was well-tolerated. Memantine treatment was associated with diminished gambling and improved cognitive flexibility. CONCLUSIONS These findings suggest that pharmacological manipulation of the glutamate system may target both gambling and cognitive deficits in PG. Placebo-controlled, double-blind studies are warranted in order to confirm these preliminary findings in a controlled design.
Collapse
Affiliation(s)
- Jon E Grant
- Department of Psychiatry, University of Minnesota School of Medicine, 2450 Riverside Avenue, Minneapolis, MN 55454, USA.
| | | | | | | | | |
Collapse
|
48
|
Odlaug BL, Grant JE. Impulse-control disorders in a college sample: results from the self-administered Minnesota Impulse Disorders Interview (MIDI). PRIMARY CARE COMPANION TO THE JOURNAL OF CLINICAL PSYCHIATRY 2010; 12. [PMID: 20694115 DOI: 10.4088/pcc.09m00842whi] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2009] [Accepted: 08/14/2009] [Indexed: 10/19/2022]
Abstract
OBJECTIVE This study sought to examine the prevalence rates of and gender differences among impulse-control disorders in a college sample. METHOD During the fall semester of 2006, 791 college students from 2 private colleges in the Midwest completed a self-administered, modified version of the Minnesota Impulse Disorders Interview to assess lifetime rates of DSM-IV-TR-diagnosed impulse-control disorders. Participation was voluntary and anonymous. RESULTS The mean age of the sample was 20.0 +/- 1.25 years, with females comprising 67.9% of the respondents. Of the individuals, 10.4% (n = 82) met criteria for at least 1 lifetime impulse-control disorder. The most common disorders were trichotillomania (3.91%) and compulsive sexual behavior (3.66%). Kleptomania was the least common (0.38%). Males were significantly more likely to screen positive for pathological gambling (P = .003) and compulsive sexual behavior (P = .002). Females were more likely to have compulsive buying (P = .033). CONCLUSIONS Impulse-control disorders appear to be common among college students. The high rates indicate that these disorders may be incipient during late adolescence and early adulthood and should be addressed prior to onset of clinical versions of the impulse-control disorder.
Collapse
Affiliation(s)
- Brian L Odlaug
- Department of Psychiatry, University of Minnesota Medical Center, Minneapolis.
| | | |
Collapse
|
49
|
Stein DJ, Grant JE, Franklin ME, Keuthen N, Lochner C, Singer HS, Woods DW. Trichotillomania (hair pulling disorder), skin picking disorder, and stereotypic movement disorder: toward DSM-V. Depress Anxiety 2010; 27:611-26. [PMID: 20533371 DOI: 10.1002/da.20700] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
In DSM-IV-TR, trichotillomania (TTM) is classified as an impulse control disorder (not classified elsewhere), skin picking lacks its own diagnostic category (but might be diagnosed as an impulse control disorder not otherwise specified), and stereotypic movement disorder is classified as a disorder usually first diagnosed in infancy, childhood, or adolescence. ICD-10 classifies TTM as a habit and impulse disorder, and includes stereotyped movement disorders in a section on other behavioral and emotional disorders with onset usually occurring in childhood and adolescence. This article provides a focused review of nosological issues relevant to DSM-V, given recent empirical findings. This review presents a number of options and preliminary recommendations to be considered for DSM-V: (1) Although TTM fits optimally into a category of body-focused repetitive behavioral disorders, in a nosology comprised of relatively few major categories it fits best within a category of motoric obsessive-compulsive spectrum disorders, (2) available evidence does not support continuing to include (current) diagnostic criteria B and C for TTM in DSM-V, (3) the text for TTM should be updated to describe subtypes and forms of hair pulling, (4) there are persuasive reasons for referring to TTM as "hair pulling disorder (trichotillomania)," (5) diagnostic criteria for skin picking disorder should be included in DSM-V or in DSM-Vs Appendix of Criteria Sets Provided for Further Study, and (6) the diagnostic criteria for stereotypic movement disorder should be clarified and simplified, bringing them in line with those for hair pulling and skin picking disorder.
Collapse
Affiliation(s)
- Dan J Stein
- Department of Psychiatry, University of Cape Town, Rondebosch, Cape Town, South Africa.
| | | | | | | | | | | | | |
Collapse
|
50
|
Winstanley CA, Zeeb FD, Bedard A, Fu K, Lai B, Steele C, Wong AC. Dopaminergic modulation of the orbitofrontal cortex affects attention, motivation and impulsive responding in rats performing the five-choice serial reaction time task. Behav Brain Res 2010; 210:263-72. [PMID: 20206211 DOI: 10.1016/j.bbr.2010.02.044] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2009] [Revised: 02/24/2010] [Accepted: 02/24/2010] [Indexed: 12/30/2022]
Abstract
Understanding the neurobiological factors underlying individual differences in impulsivity may provide valuable insight into vulnerability to impulse control disorders. Recent data implicate both the orbitofrontal cortex (OFC) and the dopaminergic system in psychiatric disorders associated with high levels of impulsivity, including substance abuse, mania and obsessive-compulsive disorder. However, the consequences of modulating dopaminergic activity within the OFC on impulsive behaviour are largely unknown. The effects of direct intra-OFC infusions of agonists and antagonists at the dopamine D(1) and D(2) receptors were therefore assessed in rats performing the five-choice serial reaction time test (5CSRT) of attention and motor impulsivity. Intra-OFC administration of SCH23390, a D(1) receptor antagonist, decreased impulsive responding in highly impulsive (HI) rats, but did not affect behaviour in less impulsive (LI) animals. Furthermore, the D(2) agonist quinpirole caused significant deficits in task performance, impairing accuracy, increasing omissions and decreasing the number of trials completed, which resembled the effects of systemic administration. In contrast, the D(1) agonist SKF 81297 had little effect on behaviour. Neither agonist increased impulsivity. These data provide partial support for the suggestion that high levels of impulsivity are associated with increased dopamine levels within the OFC, but further indicate that simulating dopamine's actions selectively at the D(1) or D(2) receptor cannot reproduce a highly impulsive phenotype. Dopaminergic activity within the OFC may therefore modulate impulsivity indirectly, perhaps in conjunction with other neurotransmitter systems. Furthermore, D(2)-mediated neurotransmission within the OFC could make a more fundamental contribution to cognitive behaviour.
Collapse
|