A unified online test battery for cognitive impulsivity reveals relationships with real-world impulsive behaviours

Impulsivity is a stable, measurable, and predictive psychological trait

Impulsivity is a personality construct frequently employed to explain and predict important human behaviors. Major inconsistencies in its definition and measurement, however, have led some researchers to call for an outright rejection of impulsivity as a psychological construct. We address this highly unsatisfactory state with a large-scale, preregistered study (N = 1,676) in which each participant completed 48 measures of impulsivity derived from 10 self-report scales and 10 behavioral tasks and reported frequencies of seven impulsivity-related behaviors (e.g., impulsive buying and social media usage); a subsample (N = 196) then completed a retest session 3 mo later. We found that correlations between self-report measures were substantially higher than those between behavioral tasks and between self-report measures and behavioral tasks. Bifactor analysis of these measures exacted one general factor of impulsivity I, akin to the general intelligence factor g, and six specific factors. Factor I was related mainly to self-report measures, had high test-retest reliability, and could predict impulsivity-related behaviors better than existing measures. We further developed a scale named the adjustable impulsivity scale (AIMS) to measure I. AIMS possesses excellent psychometric properties that are largely retained in shorter versions and could predict impulsivity-related behaviors equally well as I. These findings collectively support impulsivity as a stable, measurable, and predictive trait, indicating that it may be too early to reject it as a valid and useful psychological construct. The bifactorial structure of impulsivity and AIMS, meanwhile, significantly advance the conceptualization and measurement of construct impulsivity.

Trait impulsivity influences behavioural and physiological responses to threat in a virtual environment

Trait impulsivity represents a tendency to take action without forethought or consideration of consequences. This trait is multifaceted and can be decomposed into attentional, motor and non-planning subtypes of impulsivity. The purpose of the current study was to investigate how subtypes of trait impulsivity responded to different degrees of threat within room-scale virtual reality (VR) with respect to behaviour and level of physiological activation. Thirty-four participants were required to negotiate a virtual environment (VE) where they walked at height with the continuous threat of a virtual 'fall.' Behavioural measures related to the speed of movement, interaction frequency and risk were collected. Participants also wore ambulatory sensors to collect data from electrocardiogram (ECG) and electrodermal activity (EDA). Our results indicated that participants who scored highly on non-planning impulsivity exhibited riskier behaviour and higher skin conductance level (SCL). Participants with higher motor impulsivity interacted with more objects in the VE when threat was high, they also exhibited contradictory indicators of physiological activation. Attentional impulsivity was associated with a greater number of falls across the VE. The results demonstrate that subtypes of trait impulsivity respond to threats via different patterns of behaviour and levels of physiological activation, reinforcing the multifaceted nature of the trait.

Bridging the Gap Between Self-Report and Behavioral Laboratory Measures: A Real-Time Driving Task With Inverse Reinforcement Learning

A major challenge in assessing psychological constructs such as impulsivity is the weak correlation between self-report and behavioral task measures that are supposed to assess the same construct. To address this issue, we developed a real-time driving task called the "highway task," in which participants often exhibit impulsive behaviors mirroring real-life impulsive traits captured by self-report questionnaires. Here, we show that a self-report measure of impulsivity is highly correlated with performance in the highway task but not with traditional behavioral task measures of impulsivity (47 adults aged 18-33 years). By integrating deep neural networks with an inverse reinforcement learning (IRL) algorithm, we inferred dynamic changes of subjective rewards during the highway task. The results indicated that impulsive participants attribute high subjective rewards to irrational or risky situations. Overall, our results suggest that using real-time tasks combined with IRL can help reconcile the discrepancy between self-report and behavioral task measures of psychological constructs.

Mechanisms of cognitive disinhibition explain individual differences in adult attention deficit hyperactivity disorder traits

BACKGROUND

Attention deficit hyperactivity disorder (ADHD) in adults is strongly associated with psychiatric comorbidity and functional impairment. Here, we aimed to use a newly developed online cognitive battery with strong psychometric properties for measuring individual differences in three cognitive mechanisms proposed to underlie ADHD traits in adults: 1) attentional control - the ability to mobilize cognitive resources to stop a prepotent motor response; 2) information sampling/gathering - adequate sampling of information in a stimulus detection task prior to making a decision; and 3) shifting - the ability to adapt behavior in response to positive and negative contingencies.

METHODS

This cross-sectional and correlational study recruited 650 adults (330 males) aged 18-69 years (M = 33.06; MD = 31.00; SD = 10.50), with previously diagnosed ADHD (n = 329) and those from the general community without a history of ADHD (n = 321). Self-report measures of ADHD traits (i.e., inattention/disorganization, impulsivity, hyperactivity) and the cognitive battery were completed online.

RESULTS

Latent class analysis, exploratory structural equation modeling and factor mixture modeling revealed self-reported ADHD traits formed a unidimensional and approximately normally distributed phenotype. Bayesian structural equation modeling demonstrated that all three mechanisms measured by the cognitive battery, explained unique, incremental variance in ADHD traits, with a total of 15.9% explained in the ADHD trait factor.

CONCLUSIONS

Attentional control and shifting, as well as the less researched cognitive process of information gathering, explain individual difference variance in self-reported ADHD traits with potential to yield genetic and neurobiological insights into adult ADHD.

A Novel, Expert-Endorsed, Neurocognitive Digital Assessment Tool for Addictive Disorders: Development and Validation Study

BACKGROUND

Many people with harmful addictive behaviors may not meet formal diagnostic thresholds for a disorder. A dimensional approach, by contrast, including clinical and community samples, is potentially key to early detection, prevention, and intervention. Importantly, while neurocognitive dysfunction underpins addictive behaviors, established assessment tools for neurocognitive assessment are lengthy and unengaging, difficult to administer at scale, and not suited to clinical or community needs. The BrainPark Assessment of Cognition (BrainPAC) Project sought to develop and validate an engaging and user-friendly digital assessment tool purpose-built to comprehensively assess the main consensus-driven constructs underpinning addictive behaviors.

OBJECTIVE

The purpose of this study was to psychometrically validate a gamified battery of consensus-based neurocognitive tasks against standard laboratory paradigms, ascertain test-retest reliability, and determine their sensitivity to addictive behaviors (eg, alcohol use) and other risk factors (eg, trait impulsivity).

METHODS

Gold standard laboratory paradigms were selected to measure key neurocognitive constructs (Balloon Analogue Risk Task [BART], Stop Signal Task [SST], Delay Discounting Task [DDT], Value-Modulated Attentional Capture [VMAC] Task, and Sequential Decision-Making Task [SDT]), as endorsed by an international panel of addiction experts; namely, response selection and inhibition, reward valuation, action selection, reward learning, expectancy and reward prediction error, habit, and compulsivity. Working with game developers, BrainPAC tasks were developed and validated in 3 successive cohorts (total N=600) and a separate test-retest cohort (N=50) via Mechanical Turk using a cross-sectional design.

RESULTS

BrainPAC tasks were significantly correlated with the original laboratory paradigms on most metrics (r=0.18-0.63, P<.05). With the exception of the DDT k function and VMAC total points, all other task metrics across the 5 tasks did not differ between the gamified and nongamified versions (P>.05). Out of 5 tasks, 4 demonstrated adequate to excellent test-retest reliability (intraclass correlation coefficient 0.72-0.91, P<.001; except SDT). Gamified metrics were significantly associated with addictive behaviors on behavioral inventories, though largely independent of trait-based scales known to predict addiction risk.

CONCLUSIONS

A purpose-built battery of digitally gamified tasks is sufficiently valid for the scalable assessment of key neurocognitive processes underpinning addictive behaviors. This validation provides evidence that a novel approach, purported to enhance task engagement, in the assessment of addiction-related neurocognition is feasible and empirically defensible. These findings have significant implications for risk detection and the successful deployment of next-generation assessment tools for substance use or misuse and other mental disorders characterized by neurocognitive anomalies related to motivation and self-regulation. Future development and validation of the BrainPAC tool should consider further enhancing convergence with established measures as well as collecting population-representative data to use clinically as normative comparisons.

Improving the Reliability of Cognitive Task Measures: A Narrative Review

Cognitive tasks are capable of providing researchers with crucial insights into the relationship between cognitive processing and psychiatric phenomena. However, many recent studies have found that task measures exhibit poor reliability, which hampers their usefulness for individual differences research. Here, we provide a narrative review of approaches to improve the reliability of cognitive task measures. Specifically, we introduce a taxonomy of experiment design and analysis strategies for improving task reliability. Where appropriate, we highlight studies that are exemplary for improving the reliability of specific task measures. We hope that this article can serve as a helpful guide for experimenters who wish to design a new task, or improve an existing one, to achieve sufficient reliability for use in individual differences research.

Proof-of-concept trial of Goal Management Training+ to improve executive functions and treatment outcomes in methamphetamine use disorder

BACKGROUND

Deficits in executive function are common in methamphetamine use disorder (MUD), likely contributing to difficulties in sustained treatment success. Cognitive remediation interventions are designed to treat such deficits but have not been adapted to the needs of people with MUD. This study presents a proof-of-concept trial to evaluate a new cognitive remediation program for MUD, Goal Management Training⁺ (GMT⁺).

METHODS

This was a cluster-randomised crossover trial comparing GMT⁺ with a psychoeducation-based control (Brain Health Workshop; BHW). GMT⁺ is a therapist-administered group-based cognitive remediation for executive dysfunction comprising four 90-minute weekly sessions and daily journal activities. BHW is a lifestyle psychoeducation program matched to GMT⁺ for therapist involvement, format, and duration. Participants (n = 36; GMT n = 17; BHW n = 19) were recruited from therapeutic communities in Victoria, Australia. Primary outcomes included intervention acceptability, feasibility, and improvements in self-reported executive function. Secondary outcomes included cognitive tests of executive function, severity of methamphetamine dependence, craving, and quality of life. We performed mixed linear modelling and calculated Hedges' g effect sizes.

RESULTS

GMT⁺ participant ratings and program retention indicated high acceptability. There was no difference between GMT⁺ and BHW on self-reported executive function (g = 0.06). Cognitive tasks suggested benefits of GMT⁺ on information gathering (g = 0.88) and delay-discounting (g = 0.80). Severity of methamphetamine dependence decreased more in GMT⁺ (g = 1.47).

CONCLUSIONS

GMT⁺ was well-accepted but did not improve self-reported executive functioning. Secondary outcomes suggested GMT⁺ was beneficial for objective cognitive performance and severity of dependence.

Children's eating behaviours and related constructs: conceptual and theoretical foundations and their implications

BACKGROUND

There is a substantial body of research on children's eating behaviours (e.g., food responsiveness and fussiness) and related constructs (e.g., eating in the absence of hunger, appetite self-regulation). This research provides a foundation for understanding children's dietary intakes and healthy eating behaviours, as well as efforts at intervention, whether in relation to food avoidance, overeating and/or trajectories to excess weight gain. The success of these efforts and their associated outcomes is dependent on the theoretical foundation and conceptual clarity of the behaviours and constructs. This, in turn contributes to the coherence and precision of the definitions and measurement of these behaviours and constructs. Limited clarity in these areas ultimately creates uncertainty around the interpretation of findings from research studies and intervention programs. At present there does not appear to be an overarching theoretical framework of children's eating behaviours and associated constructs, or for separate domains of children's eating behaviours/constructs. The main purpose of the present review was to examine the possible theoretical foundations of some of the main current questionnaire and behavioural measures of children's eating behaviours and related constructs.

METHODS

We reviewed the literature on the most prominent measures of children's eating behaviours for use with children aged ~ 0-12 years. We focused on the explanations and justifications for the original design of the measures and whether these included theoretical perspectives, as well as current theoretical interpretations (and difficulties) of the behaviours and constructs.

RESULTS

We found that the most commonly used measures had their foundations in relatively applied or practical concerns rather than theoretical perspectives.

CONCLUSIONS

We concluded, consistent with Lumeng & Fisher (1), that although existing measures have served the field well, to advance the field as a science, and better contribute to knowledge development, increased attention should be directed to the conceptual and theoretical foundations of children's eating behaviours and related constructs. Suggestions for future directions are outlined.

Protocol for a cluster randomised crossover pilot trial of Goal Management Training+ (GMT+) for methamphetamine use disorder

Background

Methamphetamine use disorder (MUD) is associated with executive dysfunctions, which are linked with poorer treatment outcomes. However, current treatments for MUD do not directly address cognition. We recently modified Goal Management Training (now Goal Management Training⁺; GMT⁺), a group-based intervention originally designed to improve executive functions after brain injury, to enhance suitability for MUD. Here, we describe the rationale and design of a trial which aims to determine the acceptability and feasibility of GMT⁺ during residential rehabilitation for MUD, and its impact on executive functions and clinical outcomes.

Methods

We used a cluster randomised crossover design: participants are randomised at the cluster level to receive either GMT⁺ or psychoeducation-control (Brain Health Workshop; BHW). GMT⁺ is delivered in four 90-min weekly sessions and includes a between-session journal with 10-min daily activities. The program targets attention, impulse control, goal-setting, and decision-making. BHW is a health-oriented intervention that delivers information about the brain and promotes healthy exercise, diet, and sleep. It is matched to GMT⁺ on program format, length, and time with therapists. We will recruit forty-eight participants with MUD from residential treatment services. Our primary outcomes are acceptability, feasibility, and self-reported executive functioning. Secondary outcomes include craving, quality of life and cognitive performance. Outcome assessments are performed at baseline, post-interventions, 4-week follow-up, and 12-week follow-up.

Conclusions

This study will provide GMT⁺ feasibility and acceptability data and will indicate initial efficacy on executive functions and clinical outcomes in residential treatment for MUD. Information from this pilot trial will inform a powered RCT.

Do Rating and Task Measures of Control Abilities Assess the Same Thing?

The ability to control our thoughts and actions is broadly associated with health and success, so it is unsurprising that measuring self-control abilities is a common goal across many areas of psychology. Puzzlingly, however, different measures of control - questionnaire ratings and computerized cognitive tasks - show only weak relationships to each other. We review evidence that this discrepancy is not just a result of poor reliability or validity of ratings or tasks. Rather, ratings and tasks seem to assess different aspects of control, distinguishable along six main dimensions. To improve the psychological science surrounding self-control, it will be important for future work to investigate the relative importance of these dimensions to the dissociations between self-control measures, and for researchers to motivate and explain which aspects of control they are studying when one or both types of measures are deployed. Keywords: cognitive control, executive function, self-regulation, self-control, impulsivity.

State impulsivity amplifies urges without diminishing self-control

A disproportionate amount of research on impulsivity has focused on trait-related aspects rather than state fluctuations. As a result, the relationship between state impulsivity and moment-to-moment behaviour is unclear. Impulsivity is assumed to negatively affect self-control, but an alternative explanation, yet to be tested, could be that changes in state impulsivity and its homeostatic drivers influence the intensity of urges. We tested whether state impulsivity and hunger affected behaviour through a dual-process model, affecting both the experience of various urges, and self-control, using a smartphone-based experience sampling approach. We found that state impulsivity is associated with stronger urges, but we found no evidence of an association with diminished self-control. Being hungry amplifies urges across different types of urges, and both hunger and late hours are negatively related to the likelihood of controlling urges. These findings imply that the influence of hunger is not limited to the food domain, and provide new insight into the role of state impulsivity in daily life.

Executive Functions and Impulsivity as Transdiagnostic Correlates of Psychopathology in Childhood: A Behavioral Genetic Analysis

Executive functions (EFs) and impulsivity are dimensions of self-regulation that are both related to psychopathology. However, self-report measures of impulsivity and laboratory EF tasks typically display small correlations, and existing research indicates that impulsivity and EFs may tap separate aspects of self-regulation that independently statistically predict psychopathology in adulthood. However, relationships between EFs, impulsivity, and psychopathology may be different in childhood compared to adulthood. Here, we examine whether these patterns hold in the baseline assessment of the Adolescent Brain and Cognitive Development (ABCD) sample, a national sample of over 11,000 children (including 749 twin pairs) ages 9-10 years. We examine the phenotypic and genetic relationships among latent variables for different components of EFs and multiple facets of impulsivity. Additionally, we assess how EFs and impulsivity relate to composite measures and latent variables of psychopathology derived from parent report. EFs were weakly correlated with impulsivity, and the strength varied by impulsivity facet, emphasizing their separability. We did not identify significant genetic and environmental correlations between EFs and impulsivity. Moreover, controlling for their small relationships with each other, both EFs and some facets of impulsivity statistically predicted an Externalizing factor, attention problems, and social problems, and twin analyses suggested these relationships were genetic in origin. These findings indicate that EFs and impulsivity represent phenotypically and genetically separable aspects of self-regulation that are both transdiagnostic correlates of psychopathology in childhood.

Latent classes of maladaptive personality traits exhibit differences in social processing

OBJECTIVE

Social processing (SP) deficits manifest across numerous mental disorders. However, this research has been plagued by heterogeneity and a piecemeal approach whereby skills are examined in isolation rather than as part of an integrated cognitive system. Here, we combined two dimensional frameworks of psychopathology to address these limitations.

METHOD

We utilized the Alternative Model for Personality Disorders (AMPD) to distill trait-related heterogeneity within a community sample (n = 200), and the Research Domain Criteria (RDoC) 'Systems for Social Processes' to comprehensively assess SP. We first applied latent class analyses (LCA) to derive AMPD-based groups and subsequently contrasted the performance of these groups on a SP test battery that we developed to align with the RDoC SP constructs.

RESULTS

Our LCA yielded four distinct subgroups. The recognizable trait profiles and psychopathological symptoms of these classes suggested they were clinically meaningful. The subgroups differed in their SP profiles: one displayed deficits regarding the self, a second displayed deficits in understanding others, a third displayed more severe deficits including affiliation problems, whilst the fourth showed normal performance.

CONCLUSIONS

Our results support the link between clusters of maladaptive personality traits and distinctive profiles of SP deficits, which may inform research on disorders involving SP dysfunctions.

The Hunger Games: Homeostatic State-Dependent Fluctuations in Disinhibition Measured with a Novel Gamified Test Battery

Food homeostatic states (hunger and satiety) influence the cognitive systems regulating impulsive responses, but the direction and specific mechanisms involved in this effect remain elusive. We examined how fasting, and satiety, affect cognitive mechanisms underpinning disinhibition using a novel framework and a gamified test-battery. Thirty-four participants completed the test-battery measuring three cognitive facets of disinhibition: attentional control, information gathering and monitoring of feedback, across two experimental sessions: one after overnight fasting and another after a standardised meal. Homeostatic state was assessed using subjective self-reports and biological markers (i.e., blood-derived liver-expressed antimicrobial protein 2 (LEAP-2), insulin and leptin). We found that participants who experienced greater subjective hunger during the satiety session were more impulsive in the information gathering task; results were not confounded by changes in mood or anxiety. Homeostatic state did not significantly influence disinhibition mechanisms linked to attentional control or feedback monitoring. However, we found a significant interaction between homeostatic state and LEAP-2 on attentional control, with higher LEAP-2 associated with faster reaction times in the fasted condition only. Our findings indicate lingering hunger after eating increases impulsive behaviour via reduced information gathering. These findings identify a novel mechanism that may underpin the tendency to overeat and/or engage in broader impulsive behaviours.