Background Although impulsive personality traits have been well implicated in substance use disorder (SUD) risk, little work has established how specific impulsive personality traits influence and are influenced by SUD psychotherapy outcomes. The purpose of this meta-analysis was to quantitatively review existing work to examine 1) how impulsive personality traits affect SUD psychotherapy outcomes and 2) reductions in impulsive personality traits during SUD psychotherapy. Methods Studies were identified by conducting a comprehensive review of the literature. Results For aim one (k =6), significant effects were found for lack of premeditation (g=0.60, SE=0.30, 95% CI 0.01 to 1.20; z=1.99, p = .05) and negative urgency (g=0.55, SE=0.17, 95% CI 0.22 to 0.88, z=3.30, p=.001), with trait scores related to poorer SUD psychotherapy outcomes. For aim two (k = 10), decreases in sensation seeking (g=−0.10, SE=0.05, 95% CI −0.20 to 0.004; z=−1.88, p=.02) and negative urgency (g=−0.25, SE=0.14, 95% CI −0.53 to 0.03; z=−1.75, p=.03) during SUD psychotherapy were significant. Conclusions Overall, our quantitative synthesis suggests that lack of premeditation and negative urgency are related to poorer SUD psychotherapy outcomes. Although negative urgency and sensation seeking are decreasing during SUD psychotherapy, the magnitude of the change is quite small. Overall, we suggest that the measurement and targeting of impulsive personality traits in psychotherapy has strong potential to improve clinical outcomes across SUDs and a wide range of clinical problems and disorders.
Impulsive behavior is implicated in the initiation, maintenance, and relapse of drug-seeking behaviors involved in drug addiction. Research shows that changes in impulsive behavior across the lifespan contribute to drug use and addiction. The goal of this review is to examine existing research on the relationship between impulsive behavior and drug use across the lifespan and to recommend directions for future research. Three domains of impulsive behavior are explored in this review: impulsive behavior-related personality traits, delay discounting, and prepotent response inhibition. First, we present previous research on these three domains of impulsive behavior and drug use across developmental stages. Then, we discuss how changes in impulsive behavior across the lifespan are implicated in the progression of drug use and addiction. Finally, we discuss the relatively limited attention given to middle-to-older adults in the current literature, consider the validity of the measures used to assess impulsive behavior in middle-to-older adulthood, and suggest recommendations for future research.
Cognitive dysfunction is a core facet of schizophrenia that is present early in the course of the illness and contributes to diminished functioning and outcomes. Repetitive transcranial magnetic stimulation (rTMS) is a relatively new neuropsychiatric intervention. Initially used in treatment resistant depression, investigators are now studying rTMS for other psychiatric diseases such as schizophrenia. In this study we examined the effect of high frequency rTMS on cognitive function in a group of individuals with early phase psychosis. Twenty subjects were randomized (1:1) in double-blind fashion to rTMS or sham condition. Over two weeks subjects underwent ten sessions of high frequency, bilateral, sequential rTMS targeting the dorsolateral prefrontal cortex (DLPFC). Prior to beginning and following completion of study treatment, subjects completed a cognitive assessment and magnetic resonance imaging. Subjects receiving rTMS, compared to sham treatment, displayed improvement on a standardized cognitive battery both immediately following the course of study treatment and at follow-up two weeks later. Imaging results revealed that left frontal cortical thickness at baseline was correlated with treatment response. The study treatment was found to be safe and well tolerated. These results suggest that rTMS may hold promise for the treatment of cognitive dysfunction in the early phase of psychosis, and that MRI may provide biomarkers predicting response to the treatment.
Impulsive personality is a widely used construct for the prediction of multiple clinical problems; however, research has often disregarded important differences in its conceptualization and measurement across age and sex. The goals of this article are to test the invariance of, to compare mean differences in, and to examine the differential validity of the Urgency (negative), Premeditation (lack of), Perseverance (lack of), Sensation Seeking, with added subscale of Positive Urgency (UPPS-P) Impulsive Behavior Scale across adult age and sex. The data for this study were obtained from 799 participants in the Nathan Kline Institute’s Rockland Sample. Multigroup invariance analysis indicated full invariance of the UPPS-P Impulsive Behavior Scale across age and sex. However, invariance analysis as a function of age using Multiple-Indicators Multiple-Causes modeling identified three items with differential item functioning. Sensation Seeking was higher in males and lower as age increased. In general, age and sex did not moderate the relationships between UPPS-P traits and risk-taking behaviors, with the exception of cannabis use. Overall, the results of this study support that the UPPS-P scale can be validly used to assess and compare impulsive personality across the adult life span and sex. We suggest the removal of Items 5, 28, and 51 when using the UPPS-P with older adults to be overly cautious to age invariance effects.
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