Momentary assessment of impulsive choice and impulsive action: Reliability,stability, and correlates

Impulsivity is associated with substance use, including tobacco use. The degree to which impulsivity fluctuates over time within persons, and the degree to which such intra-individual changes can be measured reliably and validly in ambulatory assessments is not known, however. The current study evaluated two novel ambulatory measures of impulsive choice and impulsive action. Impulsive choice was measured with an eight-item delay discounting task designed to estimate the subjective value of delayed monetary rewards. Impulsive action was measured with a two-minute performance test to assess behavioral disinhibition (the inability to inhibit a motor response when signaled that such a response will not be rewarded). Valid data on impulsive choice were collected at 70% of scheduled reports and valid data on impulsive action were collected on 55% of scheduled reports, on average. Impulsive choice and action data were not normally distributed, but models of relations of these measures with within- and between-person covariates were robust across distributional assumptions. Intra-class correlations were substantial for both impulsive choice and action measures. Between persons, random intercepts in impulsive choice and action were significantly related to laboratory levels of their respective facets of impulsivity, but not self-reported or other facets of impulsivity. Validity of the ambulatory measures is supported by associations between abstinence from smoking and increased impulsivity, but challenged by an association between strong temptations to smoke and reduced impulsive choice. Results suggest that meaningful variance in impulsive choice and action can be captured using ambulatory methods, but that additional measure refinement is needed.     

Dimensions of impulsive behavior in adolescents: laboratory behavioral assessments

Impulsivity is a multifaceted construct that defines a range of maladaptive behavioral styles. The present research aimed to identify different dimensions of impulsive behavior in adolescents from a battery of laboratory behavioral assessments. In one analysis, correlations were examined between two self report and seven laboratory behavioral measures of impulsivity. The correlation between the two self report measures was high compared to correlations between the self report and laboratory behavioral measures. In a second analysis, a principal components analysis was performed with just the laboratory behavioral measures. Three behavioral dimensions were identified -- "impulsive decision-making", "impulsive inattention", and "impulsive disinhibition". These dimensions were further evaluated using the same sample with a confirmatory factor analysis, which did support the hypothesis that these are significant and independent dimensions of impulsivity. This research indicates there are at least three separate subtypes of impulsive behavior when using laboratory behavioral assessments with adolescent participants.     

Inattention,impulsive action,and subjective response to d-amphetamine

Background

Both impulsivity and sensitivity to the rewarding effects of drugs have long been considered risk factors for drug abuse. There is some preclinical evidence to suggest that the two are related; however, there is little information about how specific behavioral components of impulsivity are related to the acute euphorigenic effects of drugs in humans. The aim of the current study was to examine the degree to which both inattention and impulsive action predicted subjective response to amphetamine.

Methods

Healthy adults (n = 165) performed the behavioral tasks and rated their subjective response to amphetamine (0, 5, 10, and 20 mg). Inattention was assessed as attention lapses on a simple reaction time task, and impulsive action was measured by stop RT on the stop task. Subjective response to amphetamine was assessed with the Drug Effects Questionnaire (DEQ) and the Profile of Mood States (POMS).

Results

Hierarchical linear regression analyses showed significant negative associations between attention lapses and subjective response to amphetamine on DEQ measures. By contrast, stop RT was positively associated with responses on both DEQ and POMS measures. Additionally, a dose-response relationship was observed, such that the strength of these associations increased with higher doses of amphetamine.

Conclusions

These findings suggest that inattention is associated with less subjective response to amphetamine. By contrast, the heightened sensitivity to stimulant drug reward observed in individuals high in impulsive action suggests that this might be one mechanism contributing to increased risk for stimulant drug abuse in these individuals.     

Impulsive choice as a predictor of acquisition of IV cocaine self- administration and reinstatement of cocaine-seeking behavior in male and female rats

Drug abuse and impulsive choice are related in humans. In female rats, impulsive choice predicted the rate of acquisition of IV cocaine self-administration. The objectives of the present experiments were to: (a) compare impulsive choice in males and females, (b) extend previous research on impulsive choice and acquisition of cocaine self-administration to males, and (c) compare males and females during maintenance, extinction, and reinstatement of cocaine-seeking behavior. Male and female rats were trained on an adjusting delay task in which a response on one of two levers yielded one food pellet immediately, and a response on the other resulted in three pellets after an adjusting delay that decreased after responses on the immediate lever and increased after responses on the delay lever. A mean adjusted delay (MAD) was used as the quantitative measure of impulsivity. In Experiment 1, MADs were analyzed for sex differences. In Experiment 2, acquisition of cocaine self-administration was examined in rats selected for high (HiI; MADs < or =9 seconds) or low (LoI; MADs > or =13 seconds) impulsivity. In Experiment 3, HiI and LoI groups were compared on maintenance and extinction of cocaine self-administration and cocaine-primed reinstatement of drug-seeking behavior. There were no sex differences in impulsive choice; however, HiI male and female rats acquired cocaine self-administration faster than their LoI counterparts. LoI females responded more on a cocaine-associated lever during maintenance and extinction than HiI females, but HiI females showed greater reinstatement of cocaine-seeking behavior than all other groups at the highest dose tested (15 mg/kg). Thus, individual differences in impulsive choice were associated with differences in cocaine-seeking behavior. Impulsive choice and sex may be additive vulnerability factors in certain phases of drug abuse.     

Fractionating impulsivity: contrasting effects of central 5-HT depletion on different measures of impulsive behavior.

Reducing levels of 5-HT in the central nervous system has been associated with increases in impulsive behavior. However, the impulsivity construct describes a wide range of behaviors, including the inability to withhold a response, intolerance to delay of reward and perseveration of a nonrewarded response. Although these behaviors are generally studied using instrumental paradigms, impulsivity may also be reflected in simple Pavlovian tasks such as autoshaping and conditioned activity. This experiment aimed to characterize further the effects of central 5-HT depletion and to investigate whether different behavioral measures of impulsivity are inter-related, thus validating the construct. Rats received intracerebroventricular (ICV) infusions of vehicle (n=10) or the serotonergic neurotoxin 5,7-dihydroxytryptamine (n=12) which depleted forebrain 5-HT levels by about 90%. Lesioned animals showed significant increases in the speed and number of responses made in autoshaping, increased premature responding on a simple visual attentional task, enhanced expression of locomotor activity conditioned to food presentation, yet no change in impulsive choice was observed, as measured by a delay-discounting paradigm. Significant positive correlations were found between responses made in autoshaping and the level of conditioned activity, indicating a possible common basis for these behaviors, yet no correlations were found between other behavioral measures. These data strengthen and extend the hypothesis that 5-HT depletion increases certain types of impulsive responding. However, not all measures of impulsivity appear to be uniformly affected by 5-HT depletion, or correlate with each other, supporting the suggestion that impulsivity is not a unitary construct.     

Acute effects of morphine on distinct forms of impulsive behavior in rats

Rationale  Disturbances in impulse control are key features of substance abuse disorders, and conversely, many drugs of abuse are known to elicit impulsive behavior both clinically and preclinically. To date, little is known with respect to the involvement of the opioid system in impulsive behavior, although recent findings have demonstrated its involvement in delay discounting processes. The aim of the present study was to further investigate the role of the opioid system in varieties of impulsivity. Materials and methods  To this end, groups of rats were trained in the five-choice serial reaction time task (5-CSRTT) and stop-signal task (SST), operant paradigms that provide measures of inhibitory control and response inhibition, respectively. In addition, another group of rats was trained in the delayed reward paradigm, which measures the sensitivity towards delay of gratification and as such assesses impulsive choice. Results and discussion  Results demonstrated that morphine, a selective μ-opioid receptor agonist, primarily impaired inhibitory control in the 5-CSRTT by increasing premature responding. In addition, in keeping with previous data, morphine decreased the preference for the large over small reward in the delayed reward paradigm. The effects of morphine on measures of impulsivity in both the 5-CSRTT and delayed reward paradigm were blocked by naloxone, a μ-opioid receptor antagonist. Naloxone by itself did not alter impulsive behavior, suggesting limited involvement of an endogenous opioid tone in impulsivity. Response inhibition measured in the SST was neither altered by morphine nor naloxone, although some baseline-dependent effects of morphine on response inhibition were observed. Conclusion  In conclusion, the present data demonstrate that acute challenges with morphine modulate distinct forms of impulsive behavior, thereby suggesting a role for the opioid system in impulsivity.     

Serotonin Depletion Induces ‘Waiting Impulsivity' on the Human Four-Choice Serial Reaction Time Task: Cross-Species Translational Significance

Convergent results from animal and human studies suggest that reducing serotonin neurotransmission promotes impulsive behavior. Here, serotonin depletion was induced by the dietary tryptophan depletion procedure (TD) in healthy volunteers to examine the role of serotonin in impulsive action and impulsive choice. We used a novel translational analog of a rodent 5-choice serial reaction time task (5-CSRTT)— the human 4-CSRTT—and a reward delay-discounting questionnaire to measure effects on these different forms of ‘waiting impulsivity''. There was no effect of TD on impulsive choice as indexed by the reward delay-discounting questionnaire. However, TD significantly increased 4-CSRTT premature responses (or impulsive action), which is remarkably similar to the previous findings of effect of serotonin depletion on rodent 5-CSRTT performance. Moreover, the increased premature responding in TD correlated significantly with individual differences on the motor impulsivity subscale of the Barratt Impulsivity Scale. TD also improved the accuracy of performance and speeded responding, possibly indicating enhanced attention and reward processing. The results suggest: (i) the 4-CSRTT will be a valuable addition to the tests already available to measure impulsivity in humans in a direct translational analog of a test extensively used in rodents; (ii) TD in humans produces a qualitatively similar profile of effects to those in rodents (ie, enhancing premature responding), hence supporting the conclusion that TD in humans exerts at least some of its effects on central serotonin; and (iii) this manipulation of serotonin produces dissociable effects on different measures of impulsivity, suggesting considerable specificity in its modulatory role.     

Effects of the cannabinoid CB<Subscript>1</Subscript> receptor antagonist rimonabant on distinct measures of impulsive behavior in rats

Rationale Pathological impulsivity is a prominent feature in several psychiatric disorders, but detailed understanding of the specific neuronal processes underlying impulsive behavior is as yet lacking. Objectives As recent findings have suggested involvement of the brain cannabinoid system in impulsivity, the present study aimed at further elucidating the role of cannabinoid CB₁ receptor activation in distinct measures of impulsive behavior. Materials and methods The effects of the selective cannabinoid CB₁ receptor antagonist, rimonabant (SR141716A) and agonist WIN55,212-2 were tested in various measures of impulsive behavior, namely, inhibitory control in a five-choice serial reaction time task (5-CSRTT), impulsive choice in a delayed reward paradigm, and response inhibition in a stop-signal paradigm. Results In the 5-CSRTT, SR141716A dose-dependently improved inhibitory control by decreasing the number of premature responses. Furthermore, SR141716A slightly improved attentional function, increased correct response latency, but did not affect other parameters. The CB₁ receptor agonist WIN55,212-2 did not change inhibitory control in the 5-CSRTT and only increased response latencies and errors of omissions. Coadministration of WIN55,212-2 prevented the effects of SR141716A on inhibitory control in the 5-CSRTT. Impulsive choice and response inhibition were not affected by SR141716A at any dose, whereas WIN55,212-2 slightly impaired response inhibition but did not change impulsive choice. Conclusions The present data suggest that particularly the endocannabinoid system seems involved in some measures of impulsivity and provides further evidence for the existence of distinct forms of impulsivity that can be pharmacologically dissociated.     

Dissociation between long-lasting behavioral sensitization to amphetamine and impulsive choice in rats performing a delay-discounting task

RATIONALE: Repeated amphetamine (AMPH) exposure is known to cause long-term changes in AMPH-induced locomotor behavior (i.e., sensitization) that are associated with similarly long-lasting changes in brain function. It is not clear, however, if such exposure produces long-lasting changes in a cognitive behavior that, in humans, is hypothesized to contribute to addiction. OBJECTIVES: To examine whether repeated AMPH exposure induces both locomotor sensitization and alters impulsive choice in a delay-discounting task. MATERIALS AND METHODS: Adult, male Sprague-Dawley rats (n = 29) were pretreated with 3.0 mg/kg AMPH or saline every other day for 20 days and were then trained to lever press for small, immediately delivered food reinforcement or larger reinforcements delivered after delays. We subsequently assessed the effects of acute AMPH (0.1-2.0 mg/kg) on delay-discounting. Lastly, we tested for long-lasting effects of pretreatment by giving an AMPH challenge (3.0 mg/kg) 1 week after the final delay-discounting session. RESULTS: Repeated AMPH produced sensitization to the drug's stereotypy-inducing effects but did not alter acquisition or baseline behavior in the delay-discounting task. Following acute AMPH, impulsive choice and other measures of delay-discounting were altered, but to a similar extent in both saline- and AMPH-pretreated groups. The AMPH challenge, given approximately 3 months after the last pretreatment injection, revealed that sensitization was still evident. CONCLUSIONS: Our results suggest that one behavioral consequence of repeated AMPH exposure-sensitization-does not overlap with another potential outcome-increased impulsivity. Furthermore, the neuroadaptations known to be associated with sensitization may be somewhat distinct from those that lead to changes in impulsive choice.     

Acute administration of d-amphetamine decreases impulsivity in healthy volunteers.

This study investigated the acute behavioral effects of d-amphetamine on several behavioral indices of impulsivity. Impulsivity has been defined, variously, as difficulty in inhibiting inappropriate behaviors, inability to wait, insensitivity to delayed consequences or an alteration in the perception of time; standardized procedures have been developed to measure these behavioral dimensions. However, it is not known how drugs affect these measures, and few studies have examined more than one measure in a single study. In this study, 36 healthy men and women participated in three sessions, in which they received placebo, 10 mg, or 20 mg d-amphetamine in randomized order. On each session they performed the following five tasks: the Stop Task, which measures behavioral inhibition, a delay discounting task, which measures the relative value of immediate vs. delayed rewards, a delay of gratification task, a Go/No-Go task, and a time estimation task. Subjects also completed mood questionnaires. Amphetamine produced its expected subjective, mood-altering effects, including increases in POMS Friendliness and Elation scales, and ARCI Euphoria and Stimulant scales. On the measures of impulsivity, amphetamine decreased impulsive responding on three of the tasks: on the Stop Task it decreased Stop reaction times without affecting Go reaction time, on the Go/No-Go task, it decreased the number of false alarms, and on the delay discounting measure, amphetamine (20 mg) decreased k values indicating less discounting of delayed reward. Other measures of impulsive behavior were unaffected. These results suggest that acute doses of amphetamine decrease several forms of impulsive behavior. These findings extend and confirm previous findings in humans and laboratory animals.     

Trait Impulsive Choice Predicts Resistance to Extinction and Propensity to Relapse to Cocaine Seeking: A Bidirectional Investigation

Despite the strong association between impulsivity and addiction in humans, it is still a matter of debate whether impulsive choice predisposes to, or results from, drug dependence. Furthermore, it is unknown whether treating impulsivity can protect against relapse propensity. Therefore, this study explored the bidirectional relationship between impulsive choice and cocaine taking and seeking in rat behavioral models. In experiment 1, to determine whether impulsive choice predisposes to cocaine taking or seeking, rats were selected based on trait impulsivity in a delayed reward task and subsequently compared on various stages of cocaine self-administration (SA). To examine the consequence of cocaine intake on impulsive choice, impulsivity was monitored once a week throughout various stages of cocaine SA. To determine whether treating impulsive choice can protect against relapse propensity, in experiment 2, impulsive choice was manipulated by pharmacological interventions and cocaine-associated contextual cues. Trait impulsive choice as determined in experiment 1 predicted high extinction resistance and enhanced propensity to context-induced relapse in the cocaine SA model, whereas cocaine intake did not alter impulsive choice. Furthermore, acute changes in impulsive choice were not related to rates of context-induced relapse. Taken together, the current data indicate that trait impulsive choice predicts persistent cocaine seeking during extinction and enhanced propensity to relapse, whereas acute manipulations of impulsive choice had no favorable outcomes on relapse measures. These observations suggest that trait impulsivity can be used as a predictive factor for addiction liability, but treating this impulsivity does not necessarily protect against relapse.     

Effects of acute and chronic methylphenidate on delay discounting

Methylphenidate (MPH) is one of the most common therapeutics used for the treatment of attention-deficit/hyperactivity disorder (ADHD), which consists of symptoms of inattention, and/or impulsivity and hyperactivity. Acute administration of MPH has been found to decrease impulsive choice in both humans and nonhuman animals, however, little is known about potential long-term changes in impulsive choice due to chronic administration of MPH. In the present experiment, effects of acute and chronic MPH (1.0-10.0 mg/kg) were assessed on impulsive choice in the adult male Spontaneously Hypertensive Rat (SHR) to determine the extent of behavioral changes after chronic MPH exposure. Subjects chose between an immediate single food pellet and three food pellets delivered after a delay that increased within session (0 to 16 s). At relatively higher doses during acute and chronic administration, choice maintained by the larger reinforcer was disrupted when there was no delay to either outcome, suggesting that MPH may be affecting stimulus control under the current delay-discounting task. When this disruption was not observed, however, MPH effects were selective in that only one intermediate dose (3.0 mg/kg) decreased mean impulsive choice at one delay (8 s) following acute administration. The same effect was observed following chronic MPH administration except that the dose was higher (5.6 mg/kg) and the delay was shorter (4 s). Chronic administration of MPH did not show any negative indicators (e.g., an increase in impulsive choice) when administration was discontinued.     

Reward discounting as a measure of impulsive behavior in a psychiatric outpatient population

Impulsivity has been operationalized as a choice of an immediate smaller reward over a larger delayed or uncertain reward. This study examined a procedure that measures reward preference under these contingencies in psychiatric outpatients considered either at a high or low risk for engaging in impulsive behavior depending on their psychiatric diagnoses. The participants' rates of delay and uncertainty reward discounting were compared with their performances on a behavioral inhibition task and responses on a self-report personality impulsivity measure. The high-risk participants discounted delayed rewards more sharply and scored higher on the self-report impulsivity measure relative to the low-risk participants. Delay and uncertainty discounting were modestly correlated, but no other relationships were found between the other measures. Results from this study indicate that delay-discounting tasks may be sensitive to at least one form of impulsive behavior.     

Impulsive action and impulsive choice are mediated by distinct neuropharmacological substrates in rat

Impulsivity is a heterogeneous construct according to clinical and preclinical behavioural measures and there is some preliminary evidence indicating distinct neurobiological substrates underlying the sub-components of impulsivity. Two preclinical assays, the five-choice serial reaction time task (5-CSRTT) and the delayed discounting task (DDT), are hypothesized to provide measures of impulsive action (premature responding) and impulsive choice (percent choice for delayed reward), respectively. In the present studies, we show that the norepinephrine reuptake inhibitor atomoxetine attenuated premature responding in the 5-CSRTT, but was ineffective in the DDT. The mixed dopamine/norepinephrine reuptake inhibitor methylphenidate exhibited an opposite profile of effects. In addition, blockade of 5-HT2A/C receptors via ketanserin decreased premature responding but had no effects on percent choice for delayed reward; blockade of 5-HT2C receptors via SB 242084 had opposite effects. Follow-up studies provided some limited evidence of additive effects of 5-HT2A/C receptor blockade on the effects of atomoxetine on impulsive action. These studies demonstrate dissociable profiles of stimulant vs. non-stimulant attention deficit hyperactivity disorder medications and 5-HT subtype-selective ligands, in the 5-CSRTT and DDT assays. Thus, the present findings support the sub-categorization of impulsivity and suggest that 5-HT receptor subtype-selective antagonists may provide therapeutic targets for disorders characterized by different forms of impulsivity.     

Impulsivity (delay discounting) for food and cocaine in male and female rats selectively bred for high and low saccharin intake

Previous research in rats indicates that delay discounting for food, a model of impulsivity, predicted the rate of acquisition of cocaine self-administration. In other studies, rats bred for high saccharin intake (HiS) acquired cocaine self-administration at higher rates than those with low saccharin intake (LoS), and female (F) rats acquired cocaine self-administration more rapidly than males (M). The purpose of this study was to examine a possible connection between impulsivity, saccharin intake, and sex by comparing M and F rats from the HiS and LoS selectively bred lines on measures of impulsivity; i.e., their rate of delay discounting for food or i.v. cocaine infusions. The adjusting delay procedure allowed rats access to 2 response levers, and a pellet dispenser or an i.v. drug infusion pump. In 4 groups (HiS M, HiS F, LoS M, LoS F) responses under a fixed-ratio (FR) 1 schedule on one lever resulted in one 45 mg pellet immediately, and responses on the other lever resulted in 3 or 6 pellets after a delay. Four additional groups received either a small cocaine (0.2, 0.4, or 0.8 mg/kg) infusion immediately or a delayed larger infusion (3x the amount of the small infusions). The delay to the larger reinforcer began at 6 s and increased or decreased by 1 s following responses on the delay or immediate levers, respectively. A mean adjusted delay (MAD) was calculated over 30 choice trials during each daily 3-hour session, and it was used as a quantitative measure of impulsivity. In groups maintained by food, HiS rats were more impulsive (lower MADs) than LoS rats, and LoS females were more impulsive than LoS males. There were no phenotype or sex differences in delay discounting for cocaine. Understanding the relationship between impulsivity and other predictors of drug abuse (e.g., sex, saccharin intake) is important in developing prevention and treatment strategies.     

Effects of methylphenidate on impulsive choice in adult humans

Rationale Several studies with nonhumans and humans have shown that stimulants decrease impulsive choices on delay-to-reinforcement (self-control) procedures. Little is known, however, about the effects of the stimulant methylphenidate on choice for delayed reinforcers in humans.Objectives The present study was designed to investigate the effects of acute methylphenidate administrations on impulsive responding in adult humans on a delay-to-reinforcement task.Methods Eleven adult males with a history of criminal behavior but no history of attention–deficit hyperactivity disorder (ADHD) participated. Impulsive responding was measured using an adjusting-delay procedure in which subjects were presented with repeated choices between a small amount of money delivered after a short delay and a larger amount of money delivered after a delay that adjusted as a function of previous choices. Subjects were exposed to four experimental sessions each day of participation and 60 min prior to the first daily session received placebo or 0.15, 0.30, or 0.60 mg/kg methylphenidate. Stable choice patterns were re-established between each methylphenidate dose.Results Individuals differed in their sensitivity to methylphenidate, but in over half of the subjects methylphenidate decreased impulsive (i.e., increased the number of self-control choices) and increased the delay to the large reinforcer. The largest increases in self-control choices tended to occur at the 0.30-mg/kg and 0.60-mg/kg doses, and the effects often persisted across multiple daily sessions. In six subjects, under at least one methylphenidate dose, the number of impulsive choices decreased to zero.Conclusions Acute methylphenidate administrations tended to decrease the number of impulsive choices in adult humans on an adjusting-delay procedure, although there were substantial individual differences in the sensitivity of choice to methylphenidate. In no case, however, did methylphenidate increase impulsive choices. These results are consistent with several recent laboratory studies with nonhumans and humans showing that stimulants increase preference for large, delayed reinforcers.     

The role of impulsive behavior in drug abuse

BACKGROUND: Impulsivity is a multifaceted construct that has recently been recognized as a factor contributing to enhanced vulnerability to drug abuse. OBJECTIVES: In the present review, we focus on two facets of impulsivity (and tasks that measure them): (1) impulsive choice (delay discounting task) and (2) inhibitory failure (go/no-go, stop signal reaction time, and five-choice serial reaction time tasks). We also describe how performance on each of these tasks is associated with drug-related behavior during phases of drug abuse that capture the essential features of addiction (acquisition, escalation, and reinstatement of drug-seeking after drug access has terminated). Three hypotheses (H) regarding the relationship between impulsivity and drug abuse are discussed: (1) increased levels of impulsivity lead to drug abuse (H1), (2) drugs of abuse increase impulsivity (H2), and (3) impulsivity and drug abuse are associated through a common third factor (H3). CONCLUSION: Impulsivity expressed as impulsive choice or inhibitory failure plays a role in several key transition phases of drug abuse. There is evidence to support all three nonexclusive hypotheses. Increased levels of impulsivity lead to acquisition of drug abuse (H1) and subsequent escalation or dysregulation of drug intake. Drugs of abuse may increase impulsivity (H2), which is an additional contributor to escalation/dysregulation. Abstinence, relapse, and treatment may be influenced by both H1 and H2. In addition, there is a relationship between impulsivity and other drug abuse vulnerability factors, such as sex, hormonal status, reactivity to nondrug rewards, and early environmental experiences that may impact drug intake during all phases of addiction (H3). Relating drug abuse and impulsivity in phases of addiction via these three hypotheses provides a heuristic model from which future experimental questions can be addressed.     

Impulsive action and impulsive choice across substance and behavioral addictions: Cause or consequence?

Substance use disorders are prevalent and debilitating. Certain behavioral syndromes (‘behavioral addictions’) characterized by repetitive habits, such as gambling disorder, stealing, shopping, and compulsive internet use, may share clinical, co-morbid, and neurobiological parallels with substance addictions. This review considers overlap between substance and behavioral addictions with a particular focus on impulsive action (inability to inhibit motor responses), and impulsive choice (preference for immediate smaller rewards to the detriment of long-term outcomes). We find that acute consumption of drugs with abuse potential is capable of modulating impulsive choice and action, although magnitude and direction of effect appear contingent on baseline function. Many lines of evidence, including findings from meta-analyses, show an association between chronic drug use and elevated impulsive choice and action. In some instances, elevated impulsive choice and action have been found to predate the development of substance use disorders, perhaps signifying their candidacy as objective vulnerability markers. Research in behavioral addictions is preliminary, and has mostly focused on impulsive action, finding this to be elevated versus controls, similar to that seen in chronic substance use disorders. Only a handful of imaging studies has explored the neural correlates of impulsive action and choice across these disorders. Key areas for future research are highlighted along with potential implications in terms of neurobiological models and treatment. In particular, future work should further explore whether the cognitive deficits identified are state or trait in nature: i.e. are evident before addiction perhaps signaling risk; or are a consequence of repetitive engagement in habitual behavior; and effects of novel agents known to modulate these cognitive abilities on various addictive disorders.     

The relationship between cigarette smoking and impulsivity: A review of personality,behavioral, and neurobiological assessment

Impulsivity is a multi-dimensional construct that broadly encompasses impaired self-regulation. Studies comparing substance users and non-users, including cigarette smokers, consistently find that users are more impulsive than non-users. However, identifying the role of impulsivity in cigarette smoking initiation, maintenance, and relapse has been challenging because of variation in how impulsivity is defined and whether it is assessed as (1) a stable personality trait, (2) a behavior (either trait or state), or (3) a neurobiological process. Personality and behavioral assessments are typically weakly correlated or uncorrelated, but both types of impulsivity have been related to brain activity in the prefrontal cortex (PFC) and associated areas. This article provides a narrative review of research pertaining to the relationship between impulsivity and cigarette smoking, including smoking initiation, maintenance, and relapse, with respect to these three methods of impulsivity assessment. This review revealed that impulsivity is associated with all stages of tobacco use. Regarding initiation, research involving adolescents suggests that differences between adult smokers and non-smokers in self-reported impulsivity appear to pre-date smoking initiation, whereas behavioral impulsivity has not been as consistently associated with adolescent smoking. Conversely, chronic exposure to nicotine and acute nicotine deprivation may also increase impulsivity. Regarding maintenance and relapse, urgency, an aspect of impulsivity that refers to the tendency to act impulsively when experiencing negative affect, seems to play a particularly important role. In future research, investigators should define impulsivity precisely and provide a rationale for the type of assessment used. Targeting impulsivity reduction may facilitate successful smoking cessation.     

Global 5-HT depletion attenuates the ability of amphetamine to decrease impulsive choice on a delay-discounting task in rats

Rationale Psychomotor stimulant drugs such as methylphenidate and amphetamine decrease impulsive behaviour in attention deficit hyperactivity disorder patients by unknown mechanisms. Although most behavioural effects of amphetamine are attributed to the dopaminergic system, some recent evidence suggests a role for serotonin in this paradoxical "calming" effect.Objectives To investigate whether forebrain serotonin depletion affects the action of amphetamine in the rat on a delayed reward task where impulsive choice is measured as the selection of a smaller immediate over a larger delayed reward.Methods Following behavioural training, rats received i.c.v. infusions of either vehicle (n=10) or the serotonergic neurotoxin 5,7-DHT (n=10). Post-operatively, animals received i.p. d-amphetamine (0.3,1.0,1.5, and 2.3 mg/kg/ml), and d-amphetamine co-administered with the dopamine antagonist cis-z-flupenthixol.Results 5,7-DHT (i.c.v.) itself did not affect choice behaviour, despite depleting forebrain serotonin levels by over 85%. Amphetamine increased choice for the large reward, i.e. decreased impulsivity. This effect was attenuated by 5-HT depletion, particularly in animals showing a high level of impulsive choice. Co-administration of cis-z-flupenthixol (0.125 mg/kg) with d-amphetamine abolished the effect of amphetamine in the lesioned group, whereas this was only partially attenuated in the vehicle control group.Conclusions These data suggest that the ability of amphetamine to decrease impulsivity is not solely due to its effects on dopaminergic systems, but may also depend on serotonergic neurotransmission.