The association between gaming disorder and impulsivity: A systematic review / Associação entre transtornos por jogos eletrônicos e impulsividade: uma revisão sistemática

Objective Impulsivity has been robustly linked to various addictions, including behavioral addictions. This systematic review aimed to investigate possible relationships between impulsivity and gaming disorder. Method A total of 1,710 empirical studies, without date or language restrictions, were retrieved from Biblioteca Virtual em Saúde, Cumulative Index to Nursing and Allied Health Literature, PubMed, PsycNET, Scopus, and Web of Science databases. In total, 16 studies met the inclusion criteria and were included for extraction, quantitative analysis, and integrative synthesis. Results Overall, a positive association was observed between gaming disorder and both self-reported measures of impulsivity and behavioral measures of impulsivity. Gaming disorder was associated with the presence of high-risk trends, high sensitivity to rewards, reduced inhibitory control, and low self-control among video game players. Conclusion The present systematic review provides preliminary support for the robust association between impulsivity and gaming disorder. However, given the methodological heterogeneity in assessment instruments and statistical procedures, the identified association should be interpreted cautiously.

Objetivo A impulsividade tem estado fortemente ligada a vários tipos de dependência, incluindo as dependências comportamentais. Esta revisão sistemática visou investigar possíveis relações entre a impulsividade e o transtorno por jogos eletrônicos. Método Um total de 1.710 estudos empíricos, sem restrições de data ou linguagem, foram recuperados das bases de dados Biblioteca Virtual em Saúde, Cumulative Index to Nursing and Allied Health Literature, PubMed, PsycNET, Scopus, e Web of Science. No total, 16 estudos preencheram os critérios de inclusão e foram incluídos para extração, análise quantitativa, e síntese integrativa. Resultados Observou-se uma associação positiva entre o transtorno por jogos eletrônicos e as medidas de impulsividade e de comportamento de impulsividade autorrelatadas. O transtorno por jogos eletrônicos foi associado à presença de tendências de alto risco, alta sensibilidade às recompensas, controle inibitório reduzido, e baixo autocontrole entre os jogadores. Conclusão A presente revisão fornece apoio preliminar para uma associação robusta entre a impulsividade e o transtorno por jogos eletrônicos. Contudo, dada a heterogeneidade metodológica nos instrumentos de avaliação e procedimentos estatísticos, esta associação deve ser interpretada com cautela.

Modelos neuroeconómicos explicativos de la relación entre aversión al riesgo, impulsividad y cardiocepción en estudiantes universitarios: revisión de alcance

Introducción: los modelos neuroeconómicos explican la toma de decisiones a partir de procesos neurofisiológicos, cognitivos y emocionales. La toma de decisiones se estudia a partir de otros subprocesos como la aversión al riesgo. La relación entre aversión al riesgo, impulsividad y/o interocepción es importante para determinar el rol de la conducta y cognición humanas en el mantenimiento de problemas de salud. Esto se ha estudiado en población universitaria, en la que se presentan factores de riesgo para la salud. Objetivo: sintetizar los modelos neuroeconómicos descritos en la literatura para establecer la relación entre la aversión al riesgo, impulsividad y/o la cardiocepción en estudiantes universitarios. Metodología: revisión tipo alcance realizada del 01 de junio al 30 de septiembre de 2021 en los recursos; PubMed, PsyInfo, Google Scholar, Sciencedirect, Scopus, Open dissertations y OpenGrey. Como criterio de inclusión se estableció que se tratara de investigaciones experimentales y observacionales en inglés o español en estudiantes universitarios que evaluaran la relación entre toma de decisiones, impulsividad y/o interocepción. No se filtró por fecha ni por tipo de acceso. Resultados: se rastrearon 1035 documentos, 14 cumplieron con los criterios de inclusión. Se identificaron cuatro modelos: neuroeconómico conductual, paradigma de descuento temporal, teoría biopsicológica de Gray y diferencias individuales. Se hallaron correlaciones positivas y negativas entre impulsividad, aversión al riesgo e interocepción. Conclusiones: según los estudios existe una relación entre impulsividad y aversión al riesgo, que dependiendo del modelo implementado será positiva o negativa. Las asociaciones con interocepción son poco concluyentes y requieren mayor investigación.

Introduction: neuroeconomic models explain decision making based on neurophysiological, cognitive, and emotional processes. Decision making is studied from other threads such as risk aversion. The relationship between risk aversion, impulsivity and/or interoception is important to determine the role of human behavior and cognition in the maintenance of health problems. This has been studied in the university population, in which health risk factors are present. Objective: to synthesize the neuroeconomic models described in the literature to establish the relationship between risk aversion, impulsivity and/or cardioception in university students. Methodology: scoping review carried out from June 1 to September 30, 2021, in the resources; PubMed, PsyInfo, Google Scholar, Sciencedirect, Scopus, Open dissertations, and OpenGrey. As inclusion criteria, it was established that they were experimental and observational investigations in English or Spanish in university students that evaluated the relationship between decision-making, impulsivity and/or interoception. It was not filtered by date or by type of access. Results: 1035 documents were searched, 14 met the inclusion criteria. Four models were identified: behavioral neuroeconomic, delaying discount paradigm, Gray's biopsychological theory, and individual differences. Positive and negative correlations were found between impulsivity, risk aversion, and interoception. Conclusions: according to the studies, there is a relationship between impulsivity and risk aversion, which depending on the model implemented will be positive or negative. Associations with interoception are inconclusive and require further investigation.

Sobredosis de acetaminofén y comportamientos relacionados con suicidio / Acetaminophen overdose and suicide-related behaviors / Overdose de paracetamol e comportamentos suicidas

Objetivo: este trabajo busca caracterizar el comportamiento relacionado con el suicidio en la población admitida al Hospital San Vicente Fundación, Rionegro, con sobredosis de acetaminofén entre enero 2019 y diciembre 2020 y detectar factores asociados con la dosis tóxica. Metodología: análisis descriptivo con información obtenida de historias clínicas. Resultados: 63 individuos presentaron ingestión aguda de dosis tóxica de acetaminofén como comportamiento relacionado con suicidio. Cuarenta y tres eran mujeres, 60% tenía antecedente de enfermedad psiquiátrica, 35% reportó al menos un intento suicida previo y 22% consumieron 25g o más. La lesión hepática aguda se asoció con una dosis tóxica. Conclusiones: evidenciamos una alta prevalencia de antecedente de enfermedad psi­quiátrica y comportamiento relacionado con suicidio y casi un tercio de los pacientes ingirió dosis mayores al umbral de riesgo para falla hepática. Además, la impulsividad e ingesta en casa sugiere que políticas públicas restrictivas pueden no impactar en la reducción de estos eventos en la población.

Objective: this work seeks to characterize the behavior related to suicide in the po­pulation admitted to the Hospital San Vicente Fundación, Rionegro, with an overdose of acetaminophen between January 2019 and December 2020, and to identify factors associated with the toxic dose. Methodology: descriptive analysis with information obtained from medical records. Results: 63 individuals presented acute ingestion of a toxic dose of acetaminophen as behavior related to suicide. Forty-three were women, 60% had a history of psychiatric illness, 35% reported at least one previous suicide attempt, and 22% consumed 25g or more. Acute liver injury was associated with a toxic dose. Conclusions: we evidenced a high prevalence of a history of psychiatric illness and beha­vior related to suicide; almost a third of the patients ingested doses greater than the risk threshold for liver failure. In addition, impulsiveness and eating at home suggests that res­trictive public policies may not have an impact on reducing these events in the population.

Objetivo: Este trabalho busca caracterizar o comportamento relacionado ao suicídio na população internada no Hospital San Vicente Fundación, Rionegro, com overdose de acetaminofeno entre janeiro de 2019 e dezembro de 2020 e detectar fatores associados à dose tóxica. Metodologia: análise descritiva com informações obtidas dos prontuários. Resultados: 63 indivíduos apresentaram ingestão aguda de dose tóxica de paracetamol como comportamento relacionado ao suicídio. Quarenta e três eram mulheres, 60% tinham histórico de doença psiquiátrica, 35% relataram pelo menos uma tentativa de suicídio anterior e 22% consumiram 25g ou mais. A lesão hepática aguda foi associada a uma dose tóxica. Conclusões: evidenciamos alta prevalência de história de doença psiquiátrica e com-portamento relacionado ao suicídio e quase um terço dos pacientes ingeriu doses superiores ao limiar de risco para insuficiência hepática. Além disso, a impulsividade e a alimentação em casa sugerem que políticas públicas restritivas podem não ter impacto na redução desses eventos na população.

Aggressive behavior and prognosis in patients with mild cognitive impairment / Comportamento agressivo e prognóstico em pacientes com comprometimento cognitivo

ABSTRACT The diagnosis of mild cognitive impairment (MCI) is associated with an increased risk of developing dementia. When evaluating the further prognosis of MCI, the occurrence of neuropsychiatric symptoms, particularly aggressive and impulsive behavior, may play an important role. Objective: The aim of this study was to evaluate the relationship between aggressive behavior and cognitive dysfunction in patients diagnosed with MCI. Methods: The results are based on a 7-year prospective study. At the time of inclusion in the study, participants, recruited from an outpatient clinic, were assessed with Mini-Mental State Examination (MMSE) and the Cohen-Mansfield Agitation Inventory (CMAI). A reassessment was performed after 1 year using the MMSE scale in all patients. The time of next MMSE administration was depended on the clinical condition of patients took place at the end of follow-up, that is, at the time of diagnosis of the dementia or after 7 years from inclusion when the criteria for dementia were not met. Results: Of the 193 patients enrolled in the study, 75 were included in the final analysis. Patients who converted to dementia during the observation period exhibited a greater severity of symptoms in each of the assessed CMAI categories. Moreover, there was a significant correlation between the global result of CMAI and the results of the physical nonaggressive and verbal aggressive subscales with cognitive decline during the first year of observation. Conclusions: Despite several limitations to the study, aggressive and impulsive behaviors seem to be an unfavorable prognostic factor in the course of MCI.

RESUMO O diagnóstico de comprometimento cognitivo leve (CCL) está associado a um risco aumentado de desenvolver demência. Ao avaliar o prognóstico adicional do CCL, a ocorrência de sintomas neuropsiquiátricos, particularmente o comportamento agressivo e impulsivo, pode desempenhar um papel importante. Objetivo: Avaliar a relação entre comportamento agressivo e disfunção cognitiva em indivíduos com diagnóstico de CCL. Métodos: Nossos resultados são baseados em um estudo prospectivo de sete anos. No momento da inclusão no estudo, os participantes, recrutados em um ambulatório, foram avaliados com o Mini-Exame do Estado Mental (MEEM) e o Inventário de Agitação de Cohen-Mansfield (CMAI). A reavaliação foi realizada após um ano com a escala MEEM em todos os pacientes. O momento da próxima administração do MEEM dependeu da condição clínica dos indivíduos e ocorreu no final do acompanhamento, ou seja, no momento do diagnóstico da demência ou após sete anos da inclusão, quando os critérios para demência não foram atendidos. Resultados: Dos 193 pacientes incluídos no estudo, 75 foram incluídos na análise final. Os indivíduos que converteram para demência durante o período de observação exibiram uma maior gravidade dos sintomas em cada uma das categorias avaliadas pelo CMAI. Além disso, houve uma correlação significativa entre o resultado global do CMAI e os resultados das subescalas de agressão física e verbal com declínio cognitivo durante o primeiro ano de observação. Conclusões: Apesar das várias limitações do estudo, os comportamentos agressivos e impulsivos parecem ser um fator prognóstico desfavorável no curso do CCL.

Impulsivity in migraine and in medication overuse headache: A literature review / Impulsividade na enxaqueca e na cefaleia por uso excessivo de medicamentos: uma revisão da literatura

Introduction: Psychiatric symptoms and analgesic overuse may contribute to migraine chronification. Impulsivity is a common symptom in several psychiatric disorders that can potentiate substance overuse, including analgesics. Dopamine has been associated with migraine pathophysiology and impulsivity. Objective: This review aims to assess the current knowledge about the potential association between migraine and impulsivity. Methods: PubMed and LILACS were queried using relevant descriptors related to migraine and impulsivity. Results: Five articles were selected; however, none revealed a significant correlation between migraine and impulsivity. This lack of correlation was verified in different migraine subtypes (with or without aura, chronic, or episodic). Conclusion: The heterogeneity in patient grouping and diverse impulsivity assessment tools of the studies precluded definitive conclusions. The Barratt Impulsivity Scale (BIS-11) was the most frequently used tool. Given the paucity of data and the potential impact on migraine management, further studies are crucial to elucidate the potential association between migraine and impulsivity.

Introdução: Sintomas psiquiátricos e uso excessivo de analgésicos podem contribuir para a cronificação da enxaqueca. A impulsividade é um sintoma comum em vários transtornos psiquiátricos que pode potencializar o uso excessivo de substâncias, incluindo analgésicos. A dopamina tem sido associada à fisiopatologia e impulsividade da enxaqueca. Objetivo: Esta revisão tem como objetivo avaliar o conhecimento atual sobre a potencial associação entre enxaqueca e impulsividade. Métodos: PubMed e LILACS foram consultados utilizando descritores relevantes relacionados à enxaqueca e impulsividade. Resultados: Foram selecionados cinco artigos; no entanto, nenhum revelou uma correlação significativa entre enxaqueca e impulsividade. Essa falta de correlação foi verificada em diferentes subtipos de enxaqueca (com ou sem aura, crônica ou episódica). Conclusão: A heterogeneidade no agrupamento de pacientes e as diversas ferramentas de avaliação da impulsividade dos estudos impediram conclusões definitivas. A Escala de Impulsividade Barratt (BIS-11) foi o instrumento mais utilizado. Dada a escassez de dados e o potencial impacto no tratamento da enxaqueca, mais estudos são cruciais para elucidar a potencial associação entre enxaqueca e impulsividade.

Association of deficits in prepotent response inhibition with attention deficit and impulsive behavior among children with attention deficit hyperactivity disorder / 预防医学

Objective@#To investigate the associations of deficits in prepotent response inhibition with attention deficit and impulsive behavior in children with attention deficit hyperactivity disorder (ADHD), so as to provide insights into response inhibition training in ADHD to relieve clinical symptoms. @*Methods@# From March to December 2022, 57 children with ADHD were selected from the clinical psychology department of a tertiary hospital in Hangzhou City as the ADHD group, and 55 normal children matched by age and gender were selected from a primary school as the control group. Prepotent response inhibition, attention deficit and impulsive behavior were assessed by inhibition conflict task, visual continuous performance test (CPT) and matching familiar figures test (MFFT), respectively. The associations of deficits in prepotent response inhibition with attention deficit and impulsive behavior were analyzed using multiple linear regression model, and the predictive value of deficits in prepotent response inhibition on ADHD was evaluated using receiver operating characteristic (ROC) curve.@*Results@# The children included in the ADHD group had a mean age of (8.77±1.60) years and 44 males (77.19%), and the children included in the control group had a mean age of (9.20±1.77) years and 42 males (76.36%). The error rate of inhibition conflict task, missing report rate of visual CPT and the number of MFFT errors were higher in the ADHD group than in the control group [22.50% (12.50%) vs. 8.75% (7.00%), 24.00% (30.00%) vs. 7.50% (7.00%), 8.67±3.32 vs. 4.47±3.16; all P<0.05]. Multiple linear regression model showed that the error rate of inhibition conflict task was positively associated with the missing report rate of visual CPT (R2=0.135, β=0.091, P<0.001) and the number of MFFT errors (R2=0.092, β=0.009, P<0.001). The area under the ROC curve was 0.891, the sensitivity was 93.00%, the specificity was 80.00%, and the cut-off was 13.13%.@* Conclusions @#The deficits in prepotent response inhibition are positively associated with attention deficit and impulsive behavior.

Evaluación del Modelo de Predisposición Adquirida para consumo de alcohol en adolescentes / Evaluation of the Acquired Preparedness Model for Alcohol Use in Adolescents / Avaliação do Modelo de Predisposição Adquirida para o consumo de álcool em adolescentes

Durante la adolescencia se observan altas tasas de consumo elevado de alcohol. El Modelo de Predisposición Adquirida (mpa) postula que la confluencia de factores de personalidad (como la impulsividad) y factores psicosociales (como las expectativas hacia el alcohol [ea]) predice el consumo de sustancias. Algunos resultados previos respaldan el mpa para explicar el uso de alcohol en adolescentes argentinos; sin embargo, no queda claro el modo en que distintas dimensiones de impulsividad se asocian con el uso de alcohol en esta etapa del desarrollo. El objetivo de este trabajo fue examinar, en una muestra de adolescentes argentinos, el rol mediador de las ea en la relación entre cinco dimensiones de impulsividad rasgo, medidas con la escala upps-p y la frecuencia de Consumo Episódico Elevado de Alcohol (ceea). Materiales y métodos: participaron 427 adolescentes de 13 a 18 años (58 % mujeres; M edad = 15.72, de = 1.48), escolarizados en el nivel medio (91.1 % en gestión privada). Resultados: apoyando el mpa, la tendencia a actuar precipitadamente bajo estados emocionales intensos (tanto positivos como negativos) se asoció a una mayor frecuencia de ceea vía una mayor anticipación de efectos positivos del consumo de alcohol. Urgencia positiva tuvo, además, un efecto directo sobre la frecuencia de ceea. Conclusiones: esta información puede ser de utilidad para el desarrollo de intervenciones destinadas a disminuir el desarrollo o mantenimiento de las positivas y, de esta manera, reducir el consumo de alcohol en los adolescentes.

High rates of heavy alcohol use are observed among adolescents. The Acquired Preparedness Model (apm) posits that the confluence of personality factors (e.g., impulsivity) and psychosocial factors (e.g., alcohol expectancies [aes]) predicts substance use. Research supports the use of the apmto explain alcohol use in Argentinean adolescents; however, how different dimensions of impulsivity are associ-ated with alcohol use at this developmental stage is unclear. This study was designed to examine the mediational role of aes in the relationship between multiple dimensions of trait-like impulsivity using the upps-p scale and the frequency of heavy episodic drinking (hed) in Argentinean adolescents. Materials and Methods: In this study, 427 adolescents (58% were women) with a mean age of 15.72 ± 1.48 years (range, 13­18 years) were enrolled. Results: In line with the associations proposed by the apm, this study showed that the tendency to act rashly under intense negative and positive emotions was positively associated with the frequency of hed, via the anticipation of more positive effects of alcohol use. Positive urgency also had a direct effect on the frequency of hed. This information may be useful in developing interventions to reduce positive aes to decrease adolescent alcohol use.

na adolescência observam-se altas taxas de consumo de álcool. O Modelo de Predisposição Adquirida (mpa) postula que a confluência de fatores de personalidade (como a impulsividade) e fatores psicossociais (como expectativas em relação ao álcool [ea]) prediz o uso de substâncias. Alguns resul-tados anteriores corroboram o mpa para explicar o consumo de álcool em adolescentes argentinos; no entanto, não está claro como as diferentes dimensões da impulsividade estão associadas ao consumo de álcool nesta fase do desenvolvimento. O objetivo deste trabalho foi examinar, em uma amostra de adolescentes argentinos, o papel mediador da ea na relação entre cinco dimensões do traço de impul-sividade, medidas com a escala upps-p e a frequência de Consumo Episódico Elevado de Álcool (ceea). Materiais e métodos: participaram 427 adolescentes de 13 a 18 anos (58% mulheres; M idade = 15,72; dp = 1,48), matriculados no ensino médio (91,1% em escola particular). Resultados: apoiando o mpa, mostra-se que a tendência a agir precipitadamente sob estados emocionais intensos ­tanto positivos quanto negativos­ foi associada a uma maior frequência de ceea por meio de uma maior antecipação dos efeitos positivos do consumo de álcool. A urgência positiva também teve efeito direto na frequência de ceea. Conclusões: esta informação pode ser útil para o desenvolvimento de intervenções que visem reduzir o desenvolvimento ou manutenção de ea positivas e, desta forma, reduzir o consumo de álcool em adolescentes.

Repercussões do estresse precoce nas manifestações de impulsividade em usuários de drogas / Repercussions of early stress on manifestations of impulsiveness in drug users

Objetivo: Analisar a relação entre estresse e impulsividade em indivíduos com transtornos mentais relacionados ao uso e abuso de substâncias. Método: Pesquisa transversal e analítica. Avaliações foram realizadas pelo Childhood Trauma Questionnaire e pela Escala de Impulsividade de Barrat. Resultados: A regressão linear demonstrou uma significativa previsibilidade do escore total de Impulsividade explicada pelo Childhood Trauma Questionnaire total, abuso emocional e abuso físico (p<0,05). Impulsividade motora foi significativamente prevista pelo Childhood Trauma Questionnaire total, abuso emocional, abuso físico e abuso sexual (p<0,05). Foram identificadas correlações positivas entre abuso emocional e físico com o escore de impulsividade. Nos modelos de regressão linear os abusos emocional e físico foram as principais variáveis influenciadoras da impulsividade. Conclusão: O abuso emocional e físico em usuários de drogas influencia as manifestações de impulsividade, por isso é pertinente criar estratégias que visem diminuir os impactos da impulsividade e dos fatores subjacentes.

Objective: To analyze the relationship between stress and impulsive behavior in individuals with mental disorders related to substance use and abuse. Method: Cross-sectional analytical study. Assessments were performed using the Childhood Trauma Questionnaire and the Barratt Impulsiveness Scale. Results: Linear regression demonstrated a significant predictability of the total impulsiveness score explained by the total Childhood Trauma Questionnaire, emotional abuse and physical abuse (p<0.05). Motor impulsiveness was significantly predicted by total Childhood Trauma Questionnaire, emotional abuse, physical abuse and sexual abuse (p<0.05). Positive correlations between emotional and physical abuse and the impulsiveness score were identified. In linear regression models, emotional and physical abuse were the main variables influencing impulsiveness. Conclusion:Emotional and physical abuse in drug users influences the manifestations of impulsiveness, so it is pertinent to create strategies aimed at reducing the impacts of impulsiveness and underlying factors.

The prevalence of impulsive compulsive behaviors in patients treated with apomorphine infusion: a retrospective analysis / Prevalência de comportamentos impulsivo-compulsivos em pacientes tratados com infusão de apomorfina: análise retrospectiva

ABSTRACT Background: Impulsive compulsive behaviors (ICBs) can affect a significant number of Parkinson's disease (PD) patients. Objective: We have studied brain samples from a brain bank of PD patients who received apomorphine via continuous infusion in life to assess the prevalence and outcome of ICBs. Methods: A search on the Queen Square Brain Bank (QSBB) database for cases donated from 2005 to 2016 with a pathological diagnosis of idiopathic PD was conducted. Notes of all donors who used apomorphine via continuous infusion for at least three months were reviewed. Clinical and demographic data were collected, as well as detailed information on treatment, prevalence and outcomes of ICBs. Results: 193 PD cases, 124 males and 69 females, with an average age at disease onset of 60.2 years and average disease duration of 17.2 years were reviewed. Dementia occurred in nearly half of the sample, depression in one quarter, and dyskinesias in a little over 40%. The prevalence of ICBs was 14.5%. Twenty-four individuals used apomorphine infusion for more than three months. Patients on apomorphine had younger age at disease onset, longer disease duration, and higher prevalence of dyskinesias. The prevalence of de novo ICB cases among patients on apomorphine was 8.3%. Apomorphine infusion was used for an average of 63.1 months on an average maximum dose of 79.5 mg per day. Ten patients remained on apomorphine until death. Conclusions: Apomorphine can be used as an alternative treatment for patients with previous ICBs as it has low risk of triggering recurrence of ICBs.

RESUMO Antecedentes: Comportamentos impulsivo-compulsivos (CICs) podem acometer uma parcela significativa de indivíduos com doença de Parkinson (DP). Objetivo: Nós estudamos amostras de tecido cerebral de uma população de pacientes com DP de um banco de cérebros que receberam apomorfina por infusão contínua em vida, com a finalidade de avaliar a prevalência e o desfecho dos CICs. Métodos: Uma pesquisa no banco de dados do Banco de Cérebros de Queen Square foi conduzida à procura de doações recebidas entre 2005 e 2016 com diagnóstico anatomopatológico de DP idiopática. Os prontuários de todos os doadores que usaram apomorfina por infusão contínua por um período mínimo de três meses foram revisados. Dados clínicos e demográficos foram coletados, assim como informações detalhadas sobre o tratamento, prevalência e desfecho dos CICs. Resultados: 193 casos de DP, 124 do sexo masculino e 69 do sexo feminino, com idade média de início da doença de 60,2 anos e tempo médio de duração da doença de 17,2 anos, foram revisados. Aproximadamente metade dos casos apresentaram demência, um quarto depressão, e um pouco mais de 40% discinesias. A prevalência de CICs foi 14,5%. Vinte e quatro indivíduos usaram infusão de apomorfina por mais de três meses. Os pacientes que usaram apomorfina apresentaram DP mais cedo, maior duração da doença, e uma maior prevalência de discinesias. A prevalência de novos casos de CICs entre pacientes usando apomorfina foi de 8,3%. Infusão de apomorfina foi usada em média por 63,1 meses a um dose máxima média de 79,5 mg por dia. Dez pacientes permaneceram usando apomorfina até o óbito. Conclusões: Apomorfina pode ser usada como opção de tratamento alternativo para pacientes que apresentarem CICs no passado considerando seu baixo risco de causar recorrência de CICs.

Levels of impulsivity in individuals with cannabis use disorder

Abstract Introduction Substance use disorder consists of the presence of cognitive, behavioral, and physiological symptoms, indicating continuous use of one or more substances by the individual. The literature points to the existence of a relationship between impulsive behavior, in which individuals tend to act thoughtlessly and with a lower level of planning, and consumption of substances including cannabis. Objectives To examine the presence and severity of impulsivity in individuals with cannabis use disorder and investigate associations between sociodemographic and clinical characteristics and impulsivity. Method Participants completed a sociodemographic data sheet and the Barratt Impulsiveness Scale (BIS-11). A total of 122 subjects with a diagnosis of cannabis use disorder participated, with a mean age of 34.46 years (standard deviation = 9.62). Results The prevalence of high levels of impulsivity in the sample ranged from 30 to 33%; the BIS-11 total score was significantly associated with cohabitation and alcohol use. The BIS-11 scores for motor impulsivity and attentional impulsivity were also associated with consumption of alcohol. No associations were found between impulsivity and the variables age, education, use of tobacco, or use of cocaine/crack. Conclusion This study contributes to understanding of substance dependence, especially cannabis. It found presence of impulsive behavior among individuals with cannabis use disorder, which is corroborated by reports in the literature.

Prevalence of internet addiction and its association to impulsivity, aggression, depression, and anxiety in young adult university students / Prevalências de dependência de internet e sua associação à impulsividade, agressividade, depressão e ansiedade em jovens universitários

The increasing availability of the Internet, although with many positive effects for most, has triggered addictive effects for part of the population. They experience social isolation due to Internet overuse and, when deprived of it, they feel anxiety, fissure, and psychomotor agitation. This study investigated associations among Internet addiction, demographic and cognitive variables, such as impulsivity, aggression, and depressive and/or anxiety symptoms. In this study, 1,485 young adults (67.9% women) were assessed using four psychological instruments. It was found that 19.1% of the participants presented a moderate or severe internet addiction, with men having a higher prevalence (45.0%). The risk population also included individuals who use the Internet for gaming and residents of the Northeastern region of Brazil. Moreover, a higher index of motor or attentional impulsivity, or more depressive symptoms, seems to increase the prevalence of Internet Addiction, requiring greater attention in preventive strategies.

A crescente disponibilidade de Internet, embora traga consigo inúmeros efeitos positivos para a maior parte da população, tem desencadeado efeitos aditivos para uma parcela dela. Devido ao uso excessivo da internet, essa fração da população experiencia isolamento social e sintomas de ansiedade, fissura e agitação psicomotora quando privados de Internet. Este estudo investiga associações entre a Dependência de Internet e variáveis demográficas e cognitivas como impulsividade, agressividade e sintomas depressivos e de ansiedade. Participaram do estudo 1485 jovens adultos universitários (67,9% mulheres), avaliados por meio de escalas psicológicas. Verificou-se que 19,1% apresentaram Dependência de Internet moderada ou grave, sendo que sujeitos do sexo masculino apresentaram prevalência 45,0% superior. A população de risco é composta ainda por indivíduos que utilizaram a internet para jogos e os residentes da região Nordeste do Brasil. Além disso, participantes com maior impulsividade motora e atencional e mais sintomas depressivos têm um aumento na prevalência de Dependência de Internet, e requerem maior atenção em estratégias preventivas.

Dependencia al dispositivo móvil e impulsividad en estudiantes universitarios de Riobamba-Ecuador / Mobile device dependence and impulsivity in university students from Riobamba-Ecuador

El uso excesivo de la telefonía celular crea situaciones problemáticas, resaltando la dependencia. Se realizó un estudio con el objetivo de determinar la relación entre los niveles de dependencia al dispositivo móvil y los tipos de impulsividad en universitarios; con enfoque cuantitativo, de tipo no experimental correlacional. La población de estudio estuvo conformada por 2533 estudiantes de 18 a 26 años de la Facultad de Ciencias de la Salud de la Universidad Nacional de Chimborazo, matriculados en el periodo académico agosto 2019 ­ marzo 2020. La recolección de los datos se hizo a través del Test de Dependencia al Móvil y la Escala de Impulsividad (BIS-11). La media de la edad fue de 21,3 años. El 66,5% de la muestra mostró un nivel modera-do de dependencia del dispositivo móvil. El 85,03% tenía impulsividad no planificada, con un puntaje de nivel medio de impulsividad en cada subescala y globalmente. Entre ambas variables fundamentales de estudio se estableció una correlación positiva, maderada y estadísticamente significativa

Excessive use of smartphones creates problematic situations, highlighting dependency. This study was carried out to determine the relationship between the levels of dependence on the mobile device and the types of impulsivity in university students. This research included a quantitative approach, and a non-experimental correlational type. The study population consisted of 2533 students aged 18 to 26 from the Faculty of Health Sciences of the National University of Chimborazo, enrolled in the academic period August 2019 - March 2020. Data collection was done through the Mobile Dependence Test and Impulsivity Scale (BIS-11). The mean age was 21.3 years. 66.5% of the sample showed a moderate level of dependence on the mobile device. 85.03% had unplanned impulsivity, with a score of medium level of impulsivity in each subscale and globally. A positive, lumpy, and statistically significant correlation was established between both fundamental study variables

Profile of non-suicidal self-injury in adolescents: interface with impulsiveness and loneliness

Abstract Objective: Comprehend the profile and prevalence of non-suicidal self-injury (NSSI) in adolescents and its association with impulsiveness and loneliness. Methods: Cross-sectional study carried out in 2017 in Maceió-Alagoas, Northeast Brazil, in the households of 505 adolescents aged 12-17 years, using a sample stratified and randomized by gender and neighborhood. The following instruments were used: a sociodemographic questionnaire, Brazilian version of Functional Assessment of Self-Mutilation (FASM), the Brazilian Barratt Impulsiveness Scale (BIS-11), and the Brazilian Loneliness Scale (UCLA-BR). Results: A prevalence of 6.53% was found for non-suicidal self-injury disorder (DSM-5). Significant differences ( p ≤ 0.05) were observed regarding: the most frequently used forms of NSSI were the items "cut oneself" and "scratch oneself"; engaging in three or more different forms of self-injurious behavior (66.67%) and, reporting as reasons, "to relieve feelings of emptiness or indifference" and "to stop bad feelings/sensations." Significance was also related to the sociodemographic profile: 72.73% were females and 63.54% had family income below one minimum wage. Individuals with self-injurious behavior also had higher impulsiveness and loneliness scores (p ≤ 0.05). Conclusions: The study identified a direct association between NSSI and impulsiveness and loneliness among adolescents, being more prevalent in females and in young individuals with socioeconomic vulnerability. The data provide support for improving public health policies, aimed at education, prevention, and treatment of adolescents with NSSI.

Revisión de la validez del BIS-15S para la Medición de la Impulsividad en Estudiantes Universitarios / Validity review of the BIS-15S for measuring impulsivity in university students

Resumen En 2010 se reportó la primera validación del Cuestionario de Barrat para la medición de la impulsividad de Barrat BIS15-S para población colombiana, comparando los resultados de la escala de muestras clínicas y no clínicas. El uso de esta escala se ha extendido, aunque no se han realizado más estudios sobre su validez. Este estudio reexamina la validez de esta escala para la medición de la impulsividad en una muestra colombiana de tipo no clínico. Se aplicó el instrumento a una muestra de 255 estudiantes de pregrado en Psicología. Se calculó la confiabilidad de la prueba con alfa de Cronbach; se realizó una correlación de Pearson de los resultados con los puntajes de los mismos participantes en la escala de autocontrol del 16PF5 para evaluar la validez de criterio. Además se evaluó la validez de constructo en dos análisis factoriales, uno exploratorio y otro confirmatorio sobre el supuesto de 3 factores (Motor, No planeada y Atención) reportados en la literatura previa. Se encontró una buena confiabilidad del instrumento en la muestra estudiada, además de una correlación negativa significativa (r=-,284, p<.001) de los tres factores y el puntaje total con la puntuación en autocontrol medida con el 16PF5. Los índices de ajuste del modelo factorial confirmatorio no soportan la validez de constructo del cuestionario. La estructura de tres factores no es adecuada para realizar inferencias sobre el comportamiento en participantes sin alteraciones clínicas. Se discuten los resultados y sus implicaciones en el uso de la prueba.

Abstract In 2010, the first validation of the Barrat's impulsivity questionnaire BIS15-S for the Colombian population was reported, comparing the results of the scale of clinical and non-clinical samples. The BIS15-S use is widespread although no further studies have been conducted about the validity of the scale. The present study reexamines the validity of this scale for measuring impulsivity in a non-clinical sample. The questionnaire was applied to a sample of 255 undergraduate students in Psychology. Reliability of the test was assessed through a Cronbach's alpha test, to asses criteria validity the results were correlated with the scores of the same participants in the Self-control subscale of 16PF5 through a Pearson correlation test. Also construct validity was tested in two facto analysis, it was performed an exploratory and a confirmatory factor analysis on the 3-factor assumption (Motor, not planned and Attention) reported in the previously in the literature. The results showed that the instrument had a good reliability (α=.720) in the sample studied. There was a significant negative correlation (r=-,284, p<.001) of the three factors and the total score with the self-control score measured with 16PF5. The confirmatory factorial adjustment did not support the questionnaire construct validity. The three factors structure is not adequate to make predictive inferences about behavior of participants with any clinical condition. The results and implications on the test administration are discussed.

Non-suicidal self-injury in patients with eating disorders: nuclear aspects / Autolesiones no suicidas en pacientes con trastornos de la conducta alimentaria: Aspectos nucleares

Abstract Background: Through the culture of thinness, increasingly promoted in our society as a beauty canon, it is not surprising that the number of people affected by eating disorders is increasing. Objective: This research aims to study the relationship between non-suicidal self-injuries and nuclear aspects of eating disorders specified along with this article. Methods: The sample consisted of 60 women diagnosed with anorexia and bulimia. Questionnaires assessing impulsivity, body satisfaction, alexithymia, body attitude and self-esteem were administered. Participants with non-suicidal self-harm were compared with those without it, and participants with anorexia with and without self-harm and participants with bulimia with and without self-harm were compared. Results: Differences were found in body dissatisfaction= 5.71; p ≤0.01), body attitudes= 4.80; p ≤0.02), self-esteem= 14.09; p ≤0.00) and impulsivity (t= 3.39; p ≤0.01) between participants with and without non-suicidal self-harm. Conclusions: These are key factors for the clinical area in the treatment of eating disorders to prevent the presence of self-harm, as it allows focusing the treatment target on those aspects such as dissatisfaction and impulsivity, which are key in the development of self-harm.

Resumen Introducción: A través de la cultura de la delgadez, cada vez más promovida en nuestra sociedad como canon de belleza, no es de extrañar que este aumentado el número de personas afectadas por Trastornos de Conducta alimentaria. Objetivo: Estudiar la relación entre las autolesiones no suicidas y aspectos nucleares del trastorno de conducta alimentaria que se especifican a lo largo de este artículo. Métodos: La muestra ha sido formada por 60 mujeres diagnosticadas de anorexia y bulimia. Se administraron cuestionarios que evaluaban la impulsividad, satisfacción corporal, alexitimia, actitud corporal y autoestima. Se compararon aquellas participantes que presentaban autolesiones no suicidas con las que no lo presentaban, además se compararon participantes con anorexia con y sin autolesiones y participantes con bulimia con y sin autolesiones. Resultados: Se encontraron diferencias en insatisfacción corporal = 5,71; p ≤0.01), en actitudes corporales= 4.80; p ≤0.02), autoestima= 14.09; p ≤0.00) e impulsividad, (t= 3.39; p ≤0.01) entre participantes con y sin autolesiones no suicidas. Conclusiones: Estos son factores clave para la clínica en el tratamiento de los trastornos de conducta alimentaria para prevenir la presencia de autolesiones, ya que permite enfocar el objetivo del tratamiento a aquellos aspectos como la insatisfacción e impulsividad, que son claves en el desarrollo de autolesiones.

Influence of impulsivity on adolescents pornography use / 中国学校卫生

Objective@#To explore the influence of impulsive traits of adolescent on pornography use through the analysis of the Global Early Adolescent Study(GEAS) longitudinal survey data collected in Shanghai, and to provide evidence for adolescent sexual health promotion.@*Methods@#Totally 1 512 students from grades 6 to 8 in three middle schools in a district of Shanghai were selected for the present study by stratified cluster sampling method. Baseline and two-wave follow-up investigation were conducted between 2017 and 2020. Three waves of pornography use and social demographic information were collected using electronic questionnaire through tablets while impulsivity were tested only once during the follow-up in 2018 using the paper and pencil based Barratt Impulsivity Scale, version11 (BIS-11). General statistical description and panel data statistical description, as well as multilevel mixed effect linear model were used to do the analysis.@*Results@#About 32.7% (494) of the adolescents reported the experience of watching pornography in threewave analysis. Boys were more impulsive than girls in the motor subscale (16.33±3.25, 15.66±2.93, t=4.13, P<0.01) while girls were more impulsive than boys in the nonplanning subscale (23.65±5.11, 22.83±5.21, t=-3.03, P<0.01). Mixed effect linear model result showed that impulsivity was correlated with pornography use(β=0.001, P<0.01); higher impulsivity in motor and attention were correlated with more frequent pornography use(P<0.01). Being female, perceived more parental awareness and perceived care from school adults would decrease the use of pornography while spent more than 3 hours on internet would increase the use of pornography (P<0.01).@*Conclusion@#There are stable correlations between impulsivity and pornography use. It is urgent to equip young adolescents with the necessary ability to distinguish the good from the bad in the mass and internet media world.

Impulsivity prevalence in migraine patients without and with medication overuse / Prevalência de impulsividade em pacientes com enxaqueca sem e com abuso de medicação

ABSTRACT Background: Migraine is one of the most common disorders in neurological clinical practice and is part of the group of primary headaches. It often affects individuals in the age group of 25-55 years, when people are at their peak of economic productivity. Many patients ultimately overuse analgesics. Overuse is defined by the use of analgesics for at least 15 times a month - within a minimal three-month period. Impulsivity and migraine cause losses in the lives of individuals suffering from them, as they can compromise these individuals' social, emotional, and professional spheres. Regarding the professional sphere, it results in economic losses compared with the overall population. Objective: To investigate the presence of impulsive behavior in patients with migraine and with medication-overuse migraine. Methods: Cross-sectional study on 210 female and male patients; 140 were diagnosed with migraine according to criteria of the International Classification of Headache Disorders and were subdivided into two groups (70 patients each). One of these groups was composed of medication-overuse patients; the control group was composed of non-migraine patients (70 patients). All patients were evaluated with the Barratt Impulsivity Scale (BIS-11). Results: The group of migraine patients accounted for the highest impulsivity level, followed by the control group and, finally, by the medication-overuse group. However, these differences did not attain statistical significance. Conclusions: It was not possible to establish a clear connection between migraine and impulsive behavior. Association was higher among migraineurs without medication overuse.

RESUMO Introdução: A enxaqueca é uma das condições mais comuns na prática clínica neurológica, enquadrando-se no grupo das cefaleias primárias. Sua prevalência é maior na faixa etária de 25 a 55 anos, coincidindo com o pico da produtividade econômica. Muitos pacientes recorrem ao uso abusivo de analgésicos. O uso excessivo desses medicamentos é definido pela sua utilização por pelo menos 15 vezes ao mês, por um período de no mínimo três meses. A impulsividade e a enxaqueca causam prejuízos na vida dos indivíduos afetados, podendo comprometer os âmbitos social, emocional e profissional, resultando em um prejuízo monetário a esse grupo, em relação à população em geral. Objetivo: Investigar a presença de comportamento impulsivo em pacientes com enxaqueca com abuso de analgésico. Métodos: Estudo de corte transversal com 210 pacientes, homens e mulheres, sendo 140 com diagnóstico de enxaqueca segundo os critérios da Classificação Internacional das Cefaleias (IHCD-3), subdivididos em dois grupos de 70 pacientes cada, um composto por pacientes em uso excessivo de medicamentos, e um grupo controle composto por indivíduos sem enxaqueca. Todos os pacientes foram avaliados com a Escala de Impulsividade de Barratt - BIS 11. Resultados: O grupo com enxaqueca apresentou maior impulsividade, seguido do grupo controle e, por fim, o grupo com enxaqueca com abuso de medicamentos. No entanto, essas diferenças não atingiram significância estatística. Conclusão: Não foi possível encontrar relação direta entre a enxaqueca e comportamentos impulsivos. No entanto, esta relação foi maior entre os pacientes com enxaqueca sem abuso de analgésico.

Relationship between executive functions and impulsive behavior in adolescents: Comparative study / Relación entre funciones ejecutivas y la conducta impulsiva en adolescentes: Estudio comparativo

Abstract Introduction: Impulsivity can be directly related to maladaptive and disruptive behaviors; specifically, during adolescence, impulsivity is associated with behavioral and social problems, and it has been found that some behavioral difficulties are related to neuropsychological dysfunction of the prefrontal cortex, which is responsible for regulating impulse control and executive functions. Objective To compare the relationships among executive functions, particularly inhibitory control, behavioral planning and behavioral flexibility, in adolescents between 13 and 15 years old with and without impulsivity. Method This study was developed using an analytical, comparative design. The sample consisted of 62 participants whose impulsivity was measured using the BIS-11-A Impulsiveness Scale and whose data were compared with normative data from the same sample size. Executive functions were evaluated using the Tower of London test, Modified Wisconsin Card Sorting Test (M-WCST), Trail Making Test (TMT) and Stroop test. Results Young people between 13 and 15 years old who exhibited impulsive behavior showed impairment in the executive functions studied, such as inhibitory control, cognitive flexibility, and behavioral planning. Discussion and conclusion There is a direct correlation between impulsive behaviors and executive functions during adolescence. The results found here support the development of potential intervention protocols based on executive functioning.

Resumen Introducción La impulsividad puede relacionarse directamente con conductas desadaptativas y disruptivas; en el caso concreto del periodo adolescente, la impulsividad se asocia con problemas conductuales y sociales agregados, se ha encontrado que algunas dificultades en la conducta se relacionan con una disfunción neuropsicológica de la corteza prefrontal, la cual se encarga de regular el control de impulsos y de las funciones ejecutivas. Objetivo Describir la relación entre el funcionamiento ejecutivo, particularmente control inhibitorio, la planeación conductual y la flexibilidad conductual en adolescentes de edades entre 13 y 15 años que presentan un índice de impulsividad contra datos de adolescentes que no presentan impulsividad. Método El estudio se desarrolló mediante un diseño analítico, tipo comparativo. La muestra se compuso de 62 participantes con índice de impulsividad medida a través de la BIS-11-A, muestra que después se comparó con una muestra de igual tamaño procedente de los datos normativos. Se realizó la evaluación de las funciones ejecutivas con prueba Torre de Londres, M-Wisconsin, Trail Making Test y Test Stroop. Resultados Se identificó que los jóvenes de entre 13 y 15 años que muestran conducta impulsiva presentaron también una alteración en las funciones ejecutivas estudiadas, tales como control inhibitorio, flexibilidad cognitiva y planeación conductual. Discusión y conclusión Se identificó que existe una correlación directa entre las conductas impulsivas y las funciones ejecutivas evaluadas en la etapa de la adolescencia. Los resultados encontrados aquí pueden apoyar la construcción de potenciales protocolos de intervención basados en el funcionamiento ejecutivo.

Relationship between inhibition of ongoing responses with attention deficit and behavior disorder / 中国学校卫生

Objective@#To examine the relationship between inhibition of ongoing responses deficit with attention deficit and behavior disorder among ADHD children.@*Methods@#Totally 43 children with attention deficit hyperac tivity disorder (ADHD) aged 6-14 years who met the DSM-V criteria for ADHD were recruited. And 38 health children were recruited as the control group. Vision Continuous Performance Task (CPT) and Matching Familiar Figures Test were used to assess attention deficit and behavior disorder feature of the ADHD children. Stop-signal paradigm was used to assess the inhibition of ongoing responses.@*Results@#In the stop-signal paradigm, the ADHD children’s error rate was significantly higher than typically developing children(t=4.34, P<0.01). The ADHD children error rate in the stopsignal task was positively correlated with the wrong number miss rate in CPT task(r=0.45, P<0.01), similar finding was observed in regression analysis,with inhibition of ongoing responses accounted for 20.1% of attention deficit(t=3.21,P<0.01). In ROC curve analysis, the cut-off sore was 15.50 in the task. The error rate in stop-signal task showed no association with miss rate in Matching Familiar Figures Test(r=0.09,P>0.05).@*Conclusion@#Inhibition of ongoing responses among ADHD children is associated with attention deficit, but not with existence of behavior disorder.

Exploration of socio-family and psychological characteristics of young males convicted of murder or attempted murder in the province of Buenos Aires, Argentina / Exploración de las características sociofamiliares y psicológicas en jóvenes con comportamiento homicida de la provincia de Buenos Aires, Argentina

Abstract Introduction: Different developmental and environmental vulnerability conditions can influence violent behavior in young people. Objectives: To describe the characteristics of young males who were convicted of murder or attempted murder in the province of Buenos Aires, based on indicators of maturity, impulsivity, and socio-family vulnerability. Materials and Methods: Descriptive and exploratory study. The sample consisted of 195 young men (mean: 16.8 years) imprisoned in reformatory institutions of the Province of Buenos Aires, Argentina, as they were convicted of murder (n=130), repeated murder (n=15), or attempted murder (n=50). Self and hetero-informed instruments, and professional assessment scales were used, namely: the Consideration of Future Consequences Scale (CFC); the Psychosocial Maturity Inventory (PSM); the Weinberg Adjustment Inventory (WAI); the Resistance to Peer Influence Questionnaire (RPIQ); the Psychopathy Checklist: Youth Version (PCL:YV); the Inventory of Callous Unemotional Traits (ICU), and the Barrat Impulsiveness Scale version 11 (BIS-11). Results: The distribution of the total BIS 11 and the PSM Individual Adaptation were normal (mean: 62.33 and 6.38, respectively). The mean of the total PCL:YV was 25.87. In 32.8% of the cases a first degree relative was also imprisoned. "Impulsive" and "Non-impulsive" clusters were empirically established. Conclusions: The participants' profile is characterized by several psychological and socio-family vulnerabilities that should be targeted in preventive interventions aimed at preventing violent recidivism.

Resumen Introducción. Diversas condiciones de vulnerabilidad dependientes del desarrollo y de las influencias medioambientales pueden influir en las conductas violentas juveniles. Objetivos. Describir las características de jóvenes que cometieron homicidio o intento de homicidio atendiendo a indicadores de madurez, impulsividad y vulnerabilidad sociofamiliar. Materiales y métodos. Estudio de diseño descriptivo y exploratorio. Los participantes fueron 195 varones jóvenes (media: 16.8 años) institucionalizados en la provincia de Buenos Aires, Argentina, por orden judicial por haber cometido homicidio (n=130), homicidio reiterado (n=15) o tentativa de homicidio (n=50). Se utilizaron instrumentos auto y heteroinformados y las escalas de evaluación profesional Consideration of Future Consequences Scale (CFC), Psychosocial Maturity Inventory (PSM), Weinberg Adjustment Inventory (WAI), Resistance to Peer Influence (RPI), Psychopathy Checklist: Youth Version (PCL:YV), Inventory of Callous Unemotional Traits (ICU) y Barrat Impulsiveness Scale version 11 (BIS 11). Resultados. La distribución de BIS 11 total y de PSM Adecuación Individual fueron normales, con medias de 62.33 y 6.38, respectivamente; la media de PCL: YV total fue 25.87. El 32.8% de los jóvenes tenía familiares de primer grado presos. Se configuraron empíricamente los clusters "impulsivo" y "no impulsivo". Conclusiones. El perfil de los participantes se caracteriza por diversas vulnerabilidades psicológicas y sociofamiliares que deberían ser blanco de intervención preventiva de recidiva violenta.