Impulsivity
[1] Impulsive actions are typically "poorly conceived, prematurely expressed, unduly risky, or inappropriate to the situation that often result in undesirable consequences,"[2] which imperil long-term goals and strategies for success.
"[2][5] Thus, the construct of impulsivity includes at least two independent components: first, acting without an appropriate amount of deliberation,[2] which may or may not be functional; and second, choosing short-term gains over long-term ones.
It can be considered as a normal and fundamental part of human thought processes, but also one that can become problematic, as in a condition like obsessive-compulsive disorder,[24][unreliable medical source?]
Usually, this lack of control is part of a pattern of behavior that also involves other maladaptive thoughts and actions, such as substance abuse problems or sexual disorders like the paraphilias (e.g. pedophilia and exhibitionism).
Predominantly hyperactive-impulsive type symptoms may include fidgeting and squirming in seats, talking nonstop, dashing around and touching or playing with anything in sight, having trouble sitting still during dinner/school/story time, being constantly in motion, and having difficulty doing quiet tasks or activities.
The precise genetic and environmental factors contributing to ADHD are relatively unknown, but endophenotypes offer a potential middle ground between genes and symptoms.
Problems inhibiting prepotent responses are linked with deficits in pre-frontal cortex (PFC) functioning, which is a common dysfunction associated with ADHD and other impulse-control disorders.
[citation needed] Consumption of a tempting food by non-clinical individuals increases when self-regulatory resources are previously depleted by another task, suggesting that it is caused by a breakdown in self control.
[52] There is also evidence that greater food consumption occurs when people are in a sad mood, although it is possible that this is due more to emotional regulation than to a lack of self-control.
[56] One theory suggests that binging provides a short-term escape from feelings of sadness, anger, or boredom, although it may contribute to these negative emotions in the long-term.
[79] Pathological gambling, in contrast, seems to involve many diverse aspects of impulsivity and abnormal reward circuitry (similar to substance use disorders) that has led to it being increasingly conceptualized as a non-substance or behavioral addiction.
[83] Individuals with intermittent explosive disorder, also known as impulsive aggression, have exhibited serotonergic abnormalities and show differential activation in response to emotional stimuli and situations.
[citation needed] According to the ego (or cognitive) depletion theory of impulsivity, self-control refers to the capacity for altering one's own responses, especially to bring them into line with standards such as ideals, values, morals, and social expectations, and to support the pursuit of long-term goals.
In general, automatic processes are those that are experiential in nature, occur without involving higher levels of cognition,[96] and are based on prior experiences or informal heuristics.
[100] This is often assessed using the relative value people assign to rewards at different points in time, either by asking experimental subjects to choose between alternatives or examining behavioral choices in a naturalistic setting.
[102][103] Lesions of the nucleus accumbens core subregion[104] or basolateral amygdala[105] produce shifts towards choosing the smaller-sooner reward, suggesting the involvement of these brain regions in the preference for delayed reinforcers.
[citation needed] One facet of intertemporal choice is the possibility for preference reversal, when a tempting reward becomes more highly valued than abstaining only when immediately available.
[114] Inhibitory control may itself be multifaceted, evidenced by numerous distinct inhibition constructs that can be measured in different ways, and relate to specific types of psychopathology.
Based on imaging and neural research it is theorized that the anterior cingulate, the dorsolateral prefrontal/premotor cortex, and the basal ganglia are related to interference control.
It is possible these action and inaction goals are underlying people's behavioral differences in their daily lives since they can demonstrate "patterns comparable to natural variation in overall activity levels".
[133] The assessment battery was designed to measure the following six dimensions: (a) impulsivity, (b) sensation seeking, (c) trait anxiety, (d) state depression, (e) empathy, and (f) social desirability.
[135][136] The Padua Inventory (PI) consists of 60 items describing common obsessional and compulsive behavior and allows investigation of such problems in normal and clinical subjects.
Subjects are labeled impulsive when their indifference points decline more steeply as a function of delay compared to the normal population (i.e. greater preference for immediate reward).
[citation needed] The Iowa gambling task (IGT) is a test originally meant to measure decision making specifically within individuals who have ventromedial prefrontal cortex damage.
It is derived from research in operant conditioning that provides an excellent opportunity to measure the hyperactive child's ability to inhibit behavioral responding.
[151] The orbitofrontal cortex is now thought to play a role in disinhibiting,[152] and injury to other brain structures, such as to the right inferior frontal gyrus, a specific subregion of the PFC, has been associated with deficits in stop-signal inhibition.
[154] Patients with damage to the ventromedial frontal cortex exhibit poor decision-making and persist in making risky choices in the Iowa Gambling Task.
[168] Inhibitory control training specifically is accumulating evidence that it can help individuals resist temptation to consume high calorie food[169] and drinking behavior.
[78] Evidence based pharmacological treatment for trichotillomania is not yet available, with mixed results of studies investigating the use of SSRIs, though cognitive behavioral therapy has shown positive effects.
[78] Intermittent explosive disorder is most often treated with mood stabilizers, SSRIs, beta blockers, alpha agonists, and anti-psychotics (all of which have shown positive effects).
