A test of the psychometric characteristics of the BIS-Brief among three groups of youth

Annual Research Review: The power of predictability - patterns of signals in early life shape neurodevelopment and mental health trajectories

The global burden of early life adversity (ELA) is profound. The World Health Organization has estimated that ELA accounts for almost 30% of all psychiatric cases. Yet, our ability to identify which individuals exposed to ELA will develop mental illness remains poor and there is a critical need to identify underlying pathways and mechanisms. This review proposes unpredictability as an understudied aspect of ELA that is tractable and presents a conceptual model that includes biologically plausible mechanistic pathways by which unpredictability impacts the developing brain. The model is supported by a synthesis of published and new data illustrating the significant impacts of patterns of signals on child development. We begin with an overview of the existing unpredictability literature, which has focused primarily on longer patterns of unpredictability (e.g. years, months, and days). We then describe our work testing the impact of patterns of parental signals on a moment-to-moment timescale, providing evidence that patterns of these signals during sensitive windows of development influence neurocircuit formation across species and thus may be an evolutionarily conserved process that shapes the developing brain. Next, attention is drawn to emerging themes which provide a framework for future directions of research including the evaluation of functions, such as effortful control, that may be particularly vulnerable to unpredictability, sensitive periods, sex differences, cross-cultural investigations, addressing causality, and unpredictability as a pathway by which other forms of ELA impact development. Finally, we provide suggestions for prevention and intervention, including the introduction of a screening instrument for the identification of children exposed to unpredictable experiences.

The age-varying effects of adolescent stress on impulsivity and sensation seeking

Adolescence is defined in part by heightened exposure and sensitivity to stressors. In a longitudinal cohort of youth at risk for substance use problems, we examined the age-varying relationship between stress exposure and traits that are central to the dual systems model. The positive associations between stress exposure, impulsivity, sensation seeking varied as function of age. Specifically, the influence of stress exposure on impulsivity strengthened during early adolescence and remained stable into early adulthood, while the influence of stress exposure on sensation seeking strengthened from early- to mid-adolescence and weakened thereafter. These findings suggest that the maturational imbalance between the capacity to regulate impulsive tendencies and sensation seeking may be exaggerated for youth who are exposed to a high number of stressors.

Impulsivity and Risk-Taking Behavior in School-Going Adolescents

Introduction Impulsivity (or impulsiveness) and risk-taking behavior are significant concerns as the adolescent population is at a higher risk of injuries and violence, unhealthy sexual behaviors, and drug- and alcohol-related problems. The early identification of these traits in adolescents can prove beneficial through timely interventions. This study was conducted to assess impulsive behavior and risk-taking behavior among school-going adolescents in New Delhi, India, and to study the association, if any, between the two. Methodology A cross-sectional study was conducted among 571 students of classes 9th-10th in three randomly selected schools in a part of Delhi, India. Barratt Impulsiveness Scale - Brief (BIS-Brief) was used to evaluate impulsivity, and risk-taking behavior was assessed using the RT-18 tool. Results The majority (72.3%) of the 571 students were aged 14-15 years. Among the students, 56.0% were males. The impulsivity score obtained ranged from 8 to 30, with a mean score of 15.7 (SD ±4.1). The risk-taking score ranged from 2 to 18, with a mean score of 9.9 (SD ±2.9). Impulsivity was seen to be significantly higher among the female students (p=0.004). The risk-taking behavior was significantly higher among the students from government schools, among the females, and among those who used the internet more. There was a significant direct association between impulsivity and risk-taking behavior among the students (correlation coefficient 0.301, p<0.001). Conclusion The study results showed that the mean impulsivity and risk-taking scores were comparable to other studies in adolescent age groups done internationally using the same tools. Impulsivity and risk-taking behavior were both found to be higher among females. There was a significant direct association between impulsivity and risk-taking.

Associations between inattention and impulsivity ADHD symptoms and disordered eating risk in a community sample of young adults

BACKGROUND

Symptoms of attention deficit hyperactivity disorder (ADHD) and trait impulsivity have been associated with disordered eating but are seldom assessed in community studies, or longitudinally and little is known about the mediating mechanisms.

METHODS

We tested associations between ADHD symptoms and disordered eating cross-sectionally and between trait impulsivity and disordered eating longitudinally. We utilised data from a normative cohort of young adults (642 participants: 65% female, M_age = 23 years). Participants were classified as high risk or low risk for disordered eating using the SCOFF instrument. In the first two steps of both cross-sectional and longitudinal hierarchical logistic regression models, demographics and covariates were entered. For the cross-sectional regression, Adult ADHD self-report scale (ASRS) scores, separated into inattentive and hyperactive/impulsive symptoms, were entered in the third step. In a separate longitudinal model, Barratt impulsivity scale subscales (attentional, motor and non-planning impulsivity) were entered in the third step. Depression, as assessed by the moods and feelings questionnaire (MFQ), was examined as a mediator.

RESULTS

Cross-sectionally, sex, MFQ score and inattentive symptoms predicted disordered eating risk (model R² = 20%). Longitudinally, sex, MFQ score and attentional impulsivity predicted disordered eating risk (model R² = 16%). The relationship between inattentive symptoms and the disordered eating risk was partially mediated by MFQ score, whereas the relationship between attentional impulsivity and the disordered eating risk was fully mediated by MFQ scores.

CONCLUSIONS

These data highlight (1) a specific role for inattentive symptoms of ADHD and (2) the importance of both depression and impulsivity in predicting eating disorder risk.

Psychometric Properties of the Turkish Version of the Barratt Impulsiveness Scale-Brief in Adolescents

INTRODUCTION

Barratt Impulsiveness Scale-Brief (BIS-Brief) is a self-report scale that can be used to measure impulsivity in adolescents. In this study, it was aimed to determine the psychometric properties of the Turkish version of the BIS-Brief in clinical and non-clinical adolescent samples.

METHODS

The study included two groups of 116 psychiatric outpatients and 175 middle and high school students. For the re-test study, a small subgroup of the patient group (n=21) was re-applied BIS-Brief three weeks later. Socio-demographic data of the participants were collected. Aggression subscale of Childhood Behavior Checklist (CBCL), hyperactivity/impulsivity and anger control problems subscales of Conners-Wells' Adolescents Self-Report Scale-Long (CASS-L), and hyperactivity subscale of Conner's Parent Rating Scale-Short Form (CPRS-S) were administered.

RESULTS

The mean ages of the patient and control groups were 15.22±1.58 years and 15.16±1.86 years, respectively. There were 77 (66.4%) males in the patient group and 107 (61.1%) males in the control group. Cronbach's alphas for internal consistency were 0.78 (patient group) and 0.70 (control group). Three weeks test-retest reliability was 0.64 (patient group). We found a two-dimensional structure for the Turkish BIS-Brief. The BIS-Brief scores had a significant correlation with the scores of CBCL's aggression subscale (r=0.48; p<0.01), CASS-L's hyperactivity/impulsivity (r=0.45; p<0.01) and anger control problems subscales (r=0.45; p<0.01) and CPRS-S' hyperactivity subscale (r=0.21; p<0.01).

CONCLUSION

Our findings suggest that the Turkish version of the BIS-Brief is a reliable and valid measure for clinical and non-clinical adolescent samples. In addition, the results show that the BIS-Brief has a two-dimensional model in contrast to the unidimensional structure of the original scale.

The Development of Externalizing and Internalizing Behaviors Among Youth With or Without a Family History of Substance Use Disorder: The Indirect Effects of Early-Life Stress and Impulsivity

Youth with a family history of substance use disorder (FH+) are more prone to have externalizing and internalizing problems compared to youth without a family history of substance use disorder (FH-), increasing the likelihood of later maladjustment. However, mechanisms for this association remain understudied. In this longitudinal study, we examined if FH+ youth are more likely to experience early-life stressors (ELS), which in turn would increase impulsivity and the expression of externalizing and internalizing behaviors. Data were collected from youth and a parent (n = 386) during a baseline assessment (age 10-12 years) and every six months when the youth was 13-16 years old. In support of the primary hypothesis, FH+ youth reported higher levels of externalizing and internalizing behaviors through ELS to impulsivity providing a developmental pathway through which FH+ youth are more prone to externalizing and internalizing problems.

The burden of disease of idiopathic/genetic generalized epilepsy - A nationwide online survey

The aim of the study was to assess the self-reported burden of disease in people with idiopathic/genetic generalized epilepsy and risk factors associated with high disease burden. We performed a nationwide online survey on epilepsy characteristics/treatment, quality of life/daily living followed by Standardized Assessment of Personality-Abbreviated Scale, Major Depression Inventory, Barratt Impulsiveness Scale (brief) and the brief Epilepsy Anxiety Survey Instrument. The survey was sent to 275 representative patients with IGE ('Funen cohort') and later publicly distributed via the Danish Epilepsy Association. The characteristics of the responders of the 'Funen cohort' (n = 119) did not differ from non-responders and previously assessed data. Out of 753 persons accessing the public survey, 167 had probable IGE. As compared to the 'Funen cohort', patients from the public survey reported similar age, time since last seizure, years with disease, seizure types, and IGE syndromes but more current and previously tried anti-seizure medications (ASMs). In both cohorts, patients had higher scores for depression, impulsivity, and personality disorders as compared to Danish normal values irrespective of seizure control or medication. Higher depression and anxiety scores but neither impulsivity nor personality disorders were associated with ongoing seizures. Overall health condition was estimated as bad by 28%. In the last four weeks, 20.4% reported limitations of activities of daily living due to epilepsy; 27.8% felt fed up because of their epilepsy. Patients with high subjective disease burden had more current ASMs, shorter time since last seizure and increased scores for depression, anxiety, impulsivity, and personality disorders. In conclusion, having IGE was associated with higher scores for impulsivity, depression, and personality disorders irrespective of seizure control and current treatment. High subjective disease burden was common and associated with ongoing seizures, absence/myoclonic seizures and high scores for impulsivity, depression, anxiety, and personality disorders.

The Mediating Role of Impulsivity and the Moderating Role of Gender Between Fear of Missing Out and Gaming Disorder Among a Sample of Chinese University Students

The role of fear of missing out (FoMO) in addictive behaviors has recently attracted growing attention. In view of negative effects of gaming disorder (GD) among adolescents and emerging adults, research examining the relationship between FoMO and GD is needed, alongside the roles of impulsivity and gender in the relationship between FoMO and GD. This study examined whether impulsivity as a mediator and gender as a moderator impacted on the relationship between FoMO and GD among a sample of Chinese university students. A sample of 1,288 Chinese university students from three universities completed an online survey through the Wenjuanxing platform. The Chinese Trait-State Fear of Missing Out Scale, the Barratt Impulsiveness Scale-Brief, and the Chinese Gaming Disorder Scale were used in this study. The model results indicated that impulsivity partially mediated the relationship between FoMO and GD, and that there was a larger effect size between impulsivity and GD among males. High levels of FoMO among individuals may impact on executive functions leading to more impulsivity, and are associated with GD. Gender may moderate the relationship between impulsivity and GD. This study deepens the understanding of the relationship between FoMO and GD, and provides new perspectives for practitioners to incorporate into health prevention programs to help regulate emotion, control impulsivity, and decrease GD.

Trans-diagnostic measurement of impulsivity and compulsivity: A review of self-report tools

INTRODUCTION

Impulsivity and compulsivity are important constructs, relevant to understanding behaviour in the general population, as well as in particular mental disorders (e.g. attention deficit hyperactivity disorder, obsessive-compulsive disorder). The current paper provides a narrative review of self-report impulsivity and compulsivity scales.

METHODS

A literature search was conducted using the following terms: ("impulsivity" OR "compulsivity") AND ("self-report" OR "questionnaire" OR "psychometric" OR "scale").

RESULTS

25 impulsive and 11 compulsive scales were identified, which varied considerably in psychometric properties, convenience, and validity. For impulsivity, the most commonly used scales were the BIS and the UPPS-P, whilst for compulsivity, the Padua Inventory was commonly used. The majority of compulsivity scales measured OCD symptoms (obsessions and compulsions) rather than being trans-diagnostic or specific to compulsivity (as opposed to obsessions). Scales capable of overcoming these limitations were highlighted.

DISCUSSION

This review provides clarity regarding relative advantages and disadvantages of different scales relevant to the measurement of impulsivity and compulsivity in many contexts. Areas for further research and refinement are highlighted.

Brain micro-architecture and disinhibition: a latent phenotyping study across 33 impulsive and compulsive behaviours

Impulsive and compulsive symptoms are common, tend to co-occur, and collectively account for a substantive global disease burden. Latent phenotyping offers a promising approach to elucidate common neural mechanisms conferring vulnerability to such symptoms in the general population. We utilised the Neuroscience in Psychiatry Network (NSPN), a cohort of young people (aged 18-29 years) in the United Kingdom, who provided questionnaire data and Magnetic Resonance Imaging scans. Partial Least Squares was used to identify brain regions in which intra-cortical myelination (measured using Magnetisation Transfer, MT) was significantly associated with a disinhibition phenotype, derived from bi-factor modelling of 33 impulsive and compulsive problem behaviours. The neuroimaging sample comprised 126 participants, mean 22.8 (2.7 SD) years old, being 61.1% female. Disinhibition scores were significantly and positively associated with higher MT in the bilateral frontal and parietal lobes. 1279 genes associated with disinhibition-related brain regions were identified, which were significantly enriched for functional biological interactions reflecting receptor signalling pathways. This study indicates common microstructural brain abnormalities contributing to a multitude of related, prevalent, problem behaviours characterised by disinhibition. Such a latent phenotyping approach provides insights into common neurobiological pathways, which may help to improve disease models and treatment approaches. Now that this latent phenotyping model has been validated in a general population sample, it can be extended into patient settings.

Exploring the Dimensions of Smartphone Distraction: Development, Validation, Measurement Invariance, and Latent Mean Differences of the Smartphone Distraction Scale (SDS)

Background: Distraction is a functional emotion regulation strategy utilized to relieve emotional distress. Within the attention economy perspective, distraction is increasingly associated with digital technology use, performance impairments and interference with higher-order cognitive processes. Research on smartphone distraction and its association with problematic smartphone use is still scarce and there is no available psychometric assessment tool to assess this cognitive and emotive process parsimoniously. Method: The present study reports the development and evaluation of the psychometric properties of the Smartphone Distraction Scale (SDS) through exploratory and confirmatory factor analysis, construct validity, gender invariance, and latent mean differences. The study was conducted in a sample of British university students (N = 1,001; M = 21.10 years, SD = 2.77). Results: The 16-item SDS was best conceptualized in a four-factor model solution comprising attention impulsiveness, online vigilance, emotion regulation, and multitasking. Construct validity was established using relevant psychosocial and mental health measures, with SDS scores being moderately associated with deficient self-regulation and problematic social media use. Gender measurement invariance was achieved at the configural, metric, and scalar levels, and latent mean differences indicated that females had significantly higher means than males across all four SDS latent factors. Discussion: The SDS presents with several strengths, including its theoretical grounding, relatively short length, and sound psychometric properties. The SDS enables the assessment of distraction, which appears to be one of the pathways to problematic smartphone use facilitating overuse and overreliance on smartphones for emotion regulation processes. The assessment of distraction in relation to problematic use in vulnerable populations may facilitate interventions that could encourage metacognition and benefit these groups by allowing sustained productivity in an increasingly disrupted work and social environment.

Trait impulsivity in Juvenile Myoclonic Epilepsy

Objective

Impulsivity is a multidimensional construct that can predispose to psychopathology. Meta‐analysis demonstrates an association between response impulsivity and Juvenile Myoclonic Epilepsy (JME), a common genetic generalized epilepsy. Here, we test the hypotheses that trait impulsivity is (i) elevated in JME compared to controls; (ii) moderated by specific seizure characteristics; and (iii) associated with psychiatric adverse effects of antiepileptic drugs (AEDs).

Methods

322 participants with JME and 126 age and gender‐matched controls completed the Barratt’s Impulsiveness Scale (BIS‐brief) alongside information on seizure history and AED use. We compared group BIS‐brief scores and assessed associations of JME BIS‐brief scores with seizure characteristics and AED adverse effects.

Results

The mean BIS‐brief score in JME was 18.1 ± 4.4 compared with 16.2 ± 4.1 in controls (P = 0.0007). Elevated impulsivity was associated with male gender (P = 0.027), frequent absence seizures (P = 0.0004) and lack of morning predominance of myoclonus (P = 0.008). High impulsivity significantly increased the odds of a psychiatric adverse event on levetiracetam (P = 0.036), but not any other psychiatric or somatic adverse effects.

Interpretation

Trait impulsivity is elevated in JME and comparable to scores in personality and neurotic disorders. Increased seizure frequency and absence of circadian seizure pattern moderate BIS score, suggesting disruption of both cortico‐striatal and thalamocortical networks as a shared mechanism between seizures and impulsivity in JME. These findings warrant consideration of impulsivity as a distinct target of intervention, and as a stratifying factor for AED treatment in JME, and perhaps other types of epilepsy. The role of impulsivity in treatment adherence and psychosocial outcome requires further investigation.

Fear of Missing Out (FoMO) and Gaming Disorder among Chinese University Students: Impulsivity and Game Time as Mediators

BACKGROUND AND AIMS

Research into the fear of missing out (FoMO) has greatly increased in recent years. Given the negative consequences of gaming disorder (GD) among a small minority of individuals, there is an increasing need for research examining the impact of FoMO on GD. However, little is known about the roles of impulsivity and gaming time as mediators in the relationship between FoMO and GD. The present study examined whether impulsivity and gaming time mediated the relationship between FoMO (trait-FoMO and state-FoMO) and GD among Chinese university students, as well as the prevalence of GD.

METHODS

A total of 1127 university students completed an online survey including the Chinese Trait-State Fear of Missing Out Scale (T-SFoMOS-C), the Barratt Impulsiveness Scale-Brief (BIS-Brief), gaming time survey, and the Chinese Gaming Disorder Scale (CGDS).

RESULTS

The prevalence of GD was 6.4% among Chinese university students. Trait-FoMO was found to indirectly impact GD via impulsivity and gamine time, whereas the direct effect of trait-FoMO on GD and the mediation effects of gaming time were not confirmed. State-FoMO impacted on GD both directly, and indirectly via the mediation effects of impulsivity as well as impulsivity and gaming time.

CONCLUSION

Trait-FoMO on GD was fully mediated via impulsivity and gaming time, whereas state-FoMO on GD was partly mediated via impulsivity and gaming time. Individuals with high levels of FoMO were more likely to show impulsivity and spend a longer time gaming, and these factors were associated with GD. These findings provide insights to incorporate into health prevention programs to help regulate emotion, control impulsivity, and decrease GD.

Mind over Matter: Testing the Efficacy of an Online Randomized Controlled Trial to Reduce Distraction from Smartphone Use

Evidence suggests a growing call for the prevention of excessive smartphone and social media use and the ensuing distraction that arises affecting academic achievement and productivity. A ten-day online randomized controlled trial with the use of smartphone apps, engaging participants in mindfulness exercises, self-monitoring and mood tracking, was implemented amongst UK university students (n = 143). Participants were asked to complete online pre- and post-intervention assessments. Results indicated high effect sizes in reduction of smartphone distraction and improvement scores on a number of self-reported secondary psychological outcomes. The intervention was not effective in reducing habitual behaviours, nomophobia, or time spent on social media. Mediation analyses demonstrated that: (i) emotional self-awareness but not mindful attention mediated the relationship between intervention effects and smartphone distraction, and (ii) online vigilance mediated the relationship between smartphone distraction and problematic social media use. The present study provides preliminary evidence of the efficacy of an intervention for decreased smartphone distraction and highlights psychological processes involved in this emergent phenomenon in the smartphone literature. Online interventions may serve as complementary strategies to reduce distraction levels and promote insight into online engagement. More research is required to elucidate the mechanisms of digital distraction and assess its implications in problematic use.

Adolescents' Addictive Phone Use: Associations with Eating Behaviors and Adiposity

Concerns have been raised about excessive or "addictive" phone use among adolescents, and the impact that addictive phone use (APU) can have on adolescent development and health. Most research on the physical health correlates of smartphone use has been limited to sleep health, whereas other outcomes, such as eating behaviors and obesity risk have not received as much attention. To address this gap in the literature, we examined the association between APU and emotion regulation difficulties, impulsivity, maladaptive eating behaviors, and adiposity in a sample of 111 adolescents. We found that APU is associated with greater emotion regulation difficulties, dysregulated eating, restrained eating, food addiction, and higher percent body fat. Further, we found that emotion regulation difficulties mediated the association between APU and dysregulated eating, restrained eating, and food addiction. Findings suggest that addictive phone use may confer increased risk for obesogenic eating behaviors and food addiction via challenges in regulating emotions.

The Structure, Measurement Invariance, and External Validity of the Barratt Impulsiveness Scale-Brief in a Sample of At-Risk Adolescents

The purpose of this study was to evaluate the factor structure and measurement invariance of the Barratt Impulsiveness Scale-Brief version (BIS-Brief) in an archival sample of 315 adolescents (81% male; 63.5% Caucasian; M_age = 16.7 years) participating in a military-style residential program for at-risk youths. Additionally, correlations between BIS scores and external measures of impulsivity-related behaviors were examined. Results showed support for a previously described two-dimensional structure for the BIS-Brief, which was invariant across racial groups. Additionally, the BIS-Brief performed similarly to the total BIS-11 score in relation to external measures of impulsivity-related behaviors. However, the two dimensions exhibited some significant differences in their associations with other measures. This study supports the utility of the BIS-Brief as a brief measure of impulsivity and suggests that the dimensions of the BIS-Brief may be useful in distinguishing how different aspects of impulsivity relate to problem behaviors such as binge drinking and self-injury.