Impulsivity and Decision Making

Zermatten, Ariane; Linden, Martial Van der; d’Acremont, Mathieu; Jermann, Françoise; Bechara, Antoine

doi:10.1097/01.nmd.0000180777.41295.65

Cited by 174 publications

(118 citation statements)

References 8 publications

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“…Indeed, variability in the IGT performances is a classical finding in healthy controls and inter-individual differences in brain mechanisms related to gender [12], age [20] or personality traits [16,41] may possibly explain this phenomenon. However, the association between IGT performances and DEX scores in stable patients might also reflect such behavioral variability in the MS population.…”

Section: Discussionmentioning

confidence: 99%

Preserved decision making ability in early multiple sclerosis

et al. 2008

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BACKGROUND: The purpose of this study was to assess decision making in patients with multiple sclerosis (MS) at the earliest clinically detectable time point of the disease. METHODS: Patients with definite MS (n = 109) or with clinically isolated syndrome (CIS, n = 56), a disease duration of 3 months to 5 years, and no or only minor neurological impairment (Expanded Disability Status Scale [EDSS] score 0-2.5) were compared to 50 healthy controls using the Iowa Gambling Task (IGT). RESULTS: The performance of definite MS, CIS patients, and controls was comparable for the two main outcomes of the IGT (learning index: p = 0.7; total score: p = 0.6). The IGT learning index was influenced by the educational level and the co-occurrence of minor depression. CIS and MS patients developing a relapse during an observation period of 15 months dated from IGT testing demonstrated a lower learning index in the IGT than patients who had no exacerbation (p = 0.02). When controlling for age, gender and education, the difference between relapsing and non-relapsing patients was at the limit of significance (p = 0.06). CONCLUSION: Decision making in a task mimicking real life decisions is generally preserved in early MS patients as compared to controls. A possible consequence of MS relapsing activity in the impairment of decision making ability is also suspected in the early phase of MS

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Section: Discussionmentioning

confidence: 99%

Preserved decision making ability in early multiple sclerosis

et al. 2008

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“…Some authors have recently proposed relating the various facets of impulsivity to specific cognitive processes, such as inhibition of prepotent reponses (for urgency), resistance to proactive interference in working memory and sustained attention (for perseverance), and decision-making ability (for premeditation) (see Gay, Rochat, Billieux, d'Acremont, & Van der Linden, 2008;Whiteside & Lynam, 2001;Zermatten, Van der Linden, d'Acremont, Jermann, & Bechara, 2005). In this perspective, the increase in impulsivity observed on the urgency, lack of premeditation and lack of perseverance dimensions in patients with TBI is congruent with the inhibition of pre-potent responses , sustained attention , decision-making processes (Levine et al, 2005), planning (Fortin, Godbout, & Braun, 2003) and working memory (e.g., VallatAzouvi, Weber, Legrand, & Azouvi, 2007) deficits observed after TBI.…”

Section: Discussionmentioning

confidence: 99%

Assessment of impulsivity after moderate to severe traumatic brain injury

Rochat

Beni

Billieux

et al. 2010

Neuropsychological Rehabilitation

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The aim of the study was to develop and validate a short questionnaire assessing four dimensions of impulsivity (urgency, lack of premeditation, lack of perseverance, sensation seeking) in patients with traumatic brain injury (TBI). To this end, 82 patients with TBI and their caregivers completed a short questionnaire adapted from the UPPS Impulsive Behavior Scale designed to assess impulsivity changes after TBI. Confirmatory factor analyses (CFAs) performed on the version of the scale completed by the relatives revealed that a hierarchical model holding that lack of premeditation and lack of perseverance are facets of a higher order construct (lack of conscientiousness), with urgency and sensation seeking as separate correlated factors, fit the data best. Urgency, lack of premeditation, and lack of perseverance increased after the TBI, whereas sensation seeking decreased. CFA failed to reveal a satisfactory model in the version of the scale completed by the patients. The psychological processes related to these impulsivity changes and the discrepancy observed between self-report and informant-report are discussed. This short questionnaire opens up interesting prospects for better comprehension and assessment of behavioural symptoms of TBI.

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“…36 Recently, a component of impulsivity called 'lack of premeditation' (engaging in an act without thinking or reflecting on its consequences) was found to be linked to disadvantageous decision making. 37 The 'somatic marker hypothesis' proposes that decision making is a process that depends on emotion, and that both the orbitofrontal cortex and the amygdala play parts in it. 36 The orbitofrontal cortex plays an important role in the regulation of emotional responses and behavior guided by predicted outcome, through inhibition of amygdala.…”

Section: 28mentioning

confidence: 99%

Fronto-limbic brain structures in suicidal and non-suicidal female patients with major depressive disorder

et al. 2006

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Our knowledge about the neurobiology of suicide is limited. It has been proposed that suicidal behavior generally requires biological abnormalities concomitant with the personality trait of impulsivity/aggression, besides an acute psychiatric illness or psychosocial stressor. We investigated fronto-limbic anatomical brain abnormalities in suicidal and non-suicidal adult female patients with unipolar depression. Our sample consisted of seven suicidal unipolar patients, 10 non-suicidal unipolar patients and 17 healthy female comparison subjects. The criterion for suicidality was one or more documented lifetime suicide attempts. A 1.5T GE Signa Imaging System running version Signa 5.4.3 software was used to acquire the magnetic resonance imaging images. All anatomical structures were measured blindly, with the subjects' identities and group assignments masked. We used analysis of covariance with age and intracranial volume as covariates and the Tukey-Kramer procedure to compare suicidal patients, non-suicidal patients and healthy comparison subjects. Suicidal patients had smaller right and left orbitofrontal cortex gray matter volumes compared with healthy comparison subjects. Suicidal patients had larger right amygdala volumes than non-suicidal patients. Abnormalities in the orbitofrontal cortex and amygdala in suicidal patients may impair decision-making and predispose these patients to act more impulsively and to attempt suicide.

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Impulsivity and Decision Making

Cited by 174 publications

References 8 publications

Preserved decision making ability in early multiple sclerosis

Preserved decision making ability in early multiple sclerosis

Assessment of impulsivity after moderate to severe traumatic brain injury

Fronto-limbic brain structures in suicidal and non-suicidal female patients with major depressive disorder

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