Validation of the German long and short versions of the UPPS-P Impulsive Behavior Scale.

OBJECTIVE: The UPPS-P Impulsive Behavior Scale is a widely used self-report measure of impulsivity, but there is currently no validated German version that includes the Positive Urgency scale. METHODS: We combined existing German translations of UPPS scales and included the Positive Urgency dimension to validate the UPPS-P in a sample of 399 participants. In addition, we developed a revised short version of the UPPS-P (SUPPS-P) with 20 items and conducted a confirmatory factor analysis (CFA) to verify the structure in an independent validation sample with 349 participants. To determine evidence of convergent and discriminant validity, we used measures of impulsivity, depression, anxiety, stress, problematic alcohol and substance use. RESULTS: CFA of the five factorial structure of the UPPS-P demonstrated acceptable fits and evidence of validity and reliability for the subscales. Psychometric characteristics of the SUPPS-P using the original item configuration were not satisfactory. As a result, we developed a revised German version of the SUPPS-P and confirmed the five-factor structure using a CFA in the validation sample. For the revised version, model fits and evidence of validity and internal consistencies were good. Associations with other constructs were as expected. For example, whereas Sensation Seeking was associated moderately with problematic alcohol use, lacking associations of Lack of Premeditation to internalizing symptoms showed evidence of discriminant validity. DISCUSSION: The German translations of both UPPS-P and SUPPS-P are valid tools for measuring impulsive behaviors. They are well-suited for exploring the associations between different facets of impulsivity and psychopathological phenomena.

Clonidine Patch for Tourette Syndrome With Attention-Deficit/Hyperactivity Disorder.

OBJECTIVE: To explore the efficacy and safety of clonidine adhesive patch in Tourette syndrome (TS) patients with comorbid attentiondeficit/hyperactivity disorder (ADHD). METHODS: This study was conducted on a sample of children and adolescents with TS who had comorbid ADHD between May 2012 and March 2015. The patients were diagnosed according to Diagnostic and Statistical Manual of Mental Disorders Fourth Edition, and were randomly assigned to four different dose groups: 1.0 mg/week, 1.5 mg/week, 2.0 mg/week and placebo group, and the symptom was evaluated by Swanson, Nolan, and Pelham Rating Scale, Version IV (SNAP-IV) and Yale Global Tic Severity Scale scales every 2 weeks. The primary outcome was tic disorders (TD) effective rate at week 8. RESULTS: One hundred and twenty-seven TS patients with comorbid ADHD in 2.0 mg/week (n=35), 1.5 mg/week (n=27), 1.0 mg/week (n=36) and placebo groups (n=29) were included in this subgroup analysis. The TD effective rate of the 2.0 mg, 1.5 mg, and 1.0 mg groups at week 8 were significantly better than that in placebo group (85.7%, 81.5%, and 86.1% vs. 20.7%, all p<0.0001). All groups demonstrated significant improvements in SNAP-IV total scale scores compared to baseline (p=0.0004), with treatment groups showing only a trend for better performance compared to placebo group at week 8, without statistical differences (22.1±15.41, 21.3±11.96, and 21.2±12.48 vs. 26.0±13.37, p=0.3385). A total of 9 adverse reactions occurred, all recovered spontaneously without additional medication. CONCLUSION: Clonidine adhesive patch could safely and effectively reduce the tic symptoms of TS patients with comorbid ADHD, and might be potentially helpful in the ADHD symptoms control.

Mindfulness, social evaluation anxiety, and self-regulation: exploring their association on impulsive behavior among athletes.

Introduction: Athletes, due to frequent physical interactions in competitive sports, are prone to impulsive behavior. Impulsive behavior is a prevalent psychological factor in sports, often leading to performance-affecting errors. This cross-sectional survey investigated the relationship between mindfulness and athletes' impulsive behavior. Methods: We sampled 403 athletes from youth training centers, universities, sports academies, and clubs in China using convenience and snowball sampling. Using AMOS v23, we analyzed the data with a structural equation model. Results: Our structural equation model confirmed that mindfulness and self-regulation inversely correlate with impulsive behavior, while social evaluation anxiety positively correlates with impulsive behavior. Furthermore, self-regulation and social evaluation anxiety serve as intermediaries in the link between mindfulness and impulsive behavior. Discussions: This research suggests introducing mindfulness meditation practices in competitive settings to improve athletes' social evaluation anxiety and enhance their self-regulation abilities, thereby boosting their psychological health and curbing impulsive behavior.

Intrinsic connectivity demonstrates a shared role of the posterior cingulate for cue reactivity in both gambling and cocaine use disorders.

Cue reactivity is relevant across addictive disorders as a process relevant to maintenance, relapse, and craving. Understanding the neurobiological foundations of cue reactivity across substance and behavioral addictions has important implications for intervention development. The present study used intrinsic connectivity distribution methods to examine functional connectivity during a cue-exposure fMRI task involving gambling, cocaine and sad videos in 22 subjects with gambling disorder, 24 with cocaine use disorder, and 40 healthy comparison subjects. Intrinsic connectivity distribution implicated the posterior cingulate cortex (PCC) at a stringent whole-brain threshold. Post-hoc analyses investigating the nature of the findings indicated that individuals with gambling disorder and cocaine use disorder exhibited decreased connectivity in the posterior cingulate during gambling and cocaine cues, respectively, as compared to other cues and compared to other groups. Brain-related cue reactivity in substance and behavioral addictions involve PCC connectivity in a content-to-disorder specific fashion. The findings suggesting that PCC-related circuitry underlies cue reactivity across substance and behavioral addictions suggests a potential biomarker for targeting in intervention development.

Association of impulsive behavior and cerebrospinal fluid/plasma oxidation and antioxidation ratio in Chinese men.

OBJECTIVES: Impulsive behavior is the precursor of many psychiatric and neurological conditions. High levels of impulsive behavior will increase health risk behavior and related injuries. Impulsive behavior is produced and regulated by central and peripheral biological factors, and oxidative stress (OS) can aggravate it. However, previous studies only showed that impulsive behavior was related to the level of the peripheral OS. Therefore, this study aims to clarify the relationship between OS and impulsive behavior in the brain and peripheral blood. METHODS: We recruited 64 Chinese men. We measured superoxide dismutase (SOD) (including copper, zinc and manganese) and nitric oxide synthase (NOS) (including total, inducible and constitutive) in cerebrospinal fluid (CSF) and plasma. The Barratt Impulsiveness Scale version 11 (BIS-11) was used to evaluate impulsive behavior. The relationship between OS and impulsive behavior was evaluated by partial correlation analysis and stepwise multiple regression analysis. RESULTS: Partial correlation analysis showed that the ratio of total NOS-to-MnSOD and iNOS-to-MnSOD in CSF were negatively correlated with the BIS-11 motor scores (r = -0.431, p = -0.001; r = -0.434, p = -0.001). Stepwise multiple regression analysis showed that the ratio of CSF iNOS-to-MnSOD was the most influential variable on the BIS-11 motor scores(ß = -0.434, t = -3.433, 95 %CI(-0.374, -0.098), p = 0.001). CONCLUSIONS AND RELEVANCE: The imbalance of central oxidation and antioxidation is related to impulsive behavior, which broadens our understanding of the correlation between impulsive behavior and OS.

Time-restricted feeding can increase food-related impulsivity: a randomized controlled trial.

OBJECTIVES: Although an increasing number of studies show that time-restricted feeding may improve metabolic health, studies examining the behavioral effects of this eating pattern are limited. This study examined the effect of time-restricted feeding on impulsivity in adults. METHODS: Thirty adults aged 25-41 years participated in this randomized controlled trial. The intervention group followed time-restricted feeding for 4 weeks and there was no energy restriction in the intervention group (n = 15) or control group (n = 15). Impulsivity was assessed before and after the intervention with the Barratt Impulsiveness Scale and the Go/NoGo task. RESULTS: The compliance rate (the percentage of days when participants had a feeding time of ≤ 8 hours/day) of the intervention group to the time-restricted feeding pattern was 92.38 ± 4.24%. The Barratt Impulsiveness Scale-11 total score of the intervention group increased from 55.53 ± 6.37 to 59.47 ± 7.67 (p = 0.02). During the Go/NoGo task, an indicator of inhibitory control, the reaction time to food and non-food stimuli was significantly shortened in the intervention group (respectively; p = 0.009, p = 0.01). In the control group, no significant change was detected in impulsivity determined by the BIS-11 or Go/NoGo task. DISCUSSION: This study showed that although time-restricted feeding may reduce body weight, it can lead to increased impulsivity and impaired inhibitory control.Trial registration: ClinicalTrials.gov identifier: NCT04960969.

Cocaine self-administration behavior is associated with subcortical and cortical morphometry measures in individuals with cocaine use disorder.

Background: Individual differences in gray-matter morphometry in the limbic system and frontal cortex have been linked to clinical features of cocaine use disorder (CUD). Self-administration paradigms can provide more direct measurements of the relationship between the regulation of cocaine use and gray-matter morphometry when compared to self-report assessments.Objectives: Our goal was to investigate associations with self-administration behavior in subcortical and cortical brain regions. We hypothesized the number of cocaine infusions self-administered would be correlated with gray-matter volumes (GMVs) in the striatum, amygdala, and hippocampus. Due to scarcity in human studies, we did not hypothesize subcortical directionality. In the frontal cortex, we hypothesized thickness would be negatively correlated with self-administered cocaine.Methods: We conducted an analysis of cocaine self-administration and structural MRI data from 33 (nFemales = 10) individuals with moderate-to-severe CUD. Self-administration lasted 60-minutes and cocaine (8, 16, or 32 mg/70 kg) was delivered on an FR1 schedule (5-minute lockout). Subcortical and cortical regression analyses were performed that included combined bilateral regions and age, experimental variables and use history as confounders.Results: Self-administered cocaine infusions were positively associated with caudal GMV (b = 0.18, p = 0.030) and negatively with putamenal GMV (b = -0.10, p = 0.041). In the cortical model, infusions were positively associated with insular thickness (b = 0.39, p = 0.008) and women appeared to self-administer cocaine more frequently (b = 0.23, p = 0.019).Conclusions: Brain morphometry features in the striatum and insula may contribute to cocaine consumption in CUD. These differences in morphometry may reflect consequences of prolonged use, predisposed vulnerability, or other possibilities.Clinical Trial Numbers: NCT01978431; NCT03471182.

Problematic pornography use across countries, genders, and sexual orientations: Insights from the International Sex Survey and comparison of different assessment tools.

BACKGROUND AND AIMS: Problematic pornography use (PPU) is a common manifestation of the newly introduced Compulsive Sexual Behavior Disorder diagnosis in the 11th edition of the International Statistical Classification of Diseases and Related Health Problems. Although cultural, gender- and sexual orientation-related differences in sexual behaviors are well documented, there is a relative absence of data on PPU outside Western countries and among women as well as gender- and sexually-diverse individuals. We addressed these gaps by (a) validating the long and short versions of the Problematic Pornography Consumption Scale (PPCS and PPCS-6, respectively) and the Brief Pornography Screen (BPS) and (b) measuring PPU risk across diverse populations. METHODS: Using data from the pre-registered International Sex Survey [n = 82 243; mean age (Mage) = 32.4 years, standard deviation = 12.5], a study across 42 countries from five continents, we evaluated the psychometric properties (i.e. factor structure, measurement invariance, and reliability) of the PPCS, PPCS-6, and BPS and examined their associations with relevant correlates (e.g. treatment-seeking). We also compared PPU risk among diverse groups (e.g. three genders). RESULTS: The PPCS, PPCS-6, and BPS demonstrated excellent psychometric properties [for example, comparative fit index = 0.985, Tucker-Lewis Index = 0.981, root mean square error of approximation = 0.060 (90% confidence interval = 0.059-0.060)] in the confirmatory factor analysis, with all PPCS' inter-factor correlations positive and strong (rs = 0.72-0.96). A total of 3.2% of participants were at risk of experiencing PPU (PPU+) based on the PPCS, with significant country- and gender-based differences (e.g. men reported the highest levels of PPU). No sexual orientation-based differences were observed. Only 4-10% of individuals in the PPU+ group had ever sought treatment for PPU, while an additional 21-37% wanted to, but did not do so for specific reasons (e.g. unaffordability). CONCLUSIONS: This study validated three measures to assess the severity of problematic pornography use across languages, countries, genders, and sexual orientations in 26 languages: the Problematic Pornography Consumption Scale (PPCS, and PPCS-6, respectively), and the Brief Pornography Screen (BPS). The problematic pornography use risk is estimated to be 3.2-16.6% of the population of 42 countries, and varies among different groups (e.g. genders) and based on the measure used.

Problematic Use of Internet Associates with Poor Quality of Life via Psychological Distress in Invididuals with ADHD.

Background: Problematic use of internet (PUI) may have negative impacts on psychological distress and quality of life (QoL). This situation might be more profound in people with attention-deficit/hyperactivity disorder (ADHD) due to poorer behavioral control and regulatory capacity. However, there is little evidence regarding mediated effects in the associations between PUI, psychological distress, and QoL in people with ADHD. Aims: To investigate mediating effects of psychological distress in the associations of problematic smartphone use (PSPU), problematic use of social media (PUSM), and problematic gaming (PG) with QoL in individuals with ADHD. Methods and Procedures: PUI behaviors of participants with ADHD (n = 99) were assessed using the Smartphone Application-Based Addiction Scale, Bergen Social Media Addiction Scale, and Internet Gaming Disorder-Short Form. Psychological distress was assessed using the Depression, Anxiety, Stress Scale and QoL using the Kid-KINDL. Outcomes and Results: Psychological distress mediated the associations between PUI and different domains of QoL, except for self-esteem QoL. There were also positively direct effects between PG and physical QoL, PUSM and friends' QoL, and PSPU and physical QoL. Conclusions and Implications: PUI may associate with poor QoL in people with ADHD via psychological distress. Programs on reducing PUI for people with ADHD are needed.

Mindfulness and impulsive behavior: exploring the mediating roles of self-reflection and coping effectiveness among high-level athletes in Central China.

Introduction: In the highly competitive field of sports, impulsive behavior by athletes not only threatens personal and team harmony but also poses significant risks to their careers and public image. Despite these behaviors often becoming the focus of public attention, their underlying causes and prevention strategies remain relatively unknown. This study delves deep into the impact of mindfulness on athletes' impulsive behavior, revealing the mediating roles of self-reflection and coping effectiveness. Methods: Using a combination of snowball and convenience sampling, a sample of 403 athletes from high-level sports teams in the Central China region participated in a questionnaire survey. The data were analyzed using Amos v.23 software. Results: The findings indicate a positive correlation between mindfulness and coping effectiveness (standardized coefficient = 0.336, p < 0.001), as well as between self-reflection and coping effectiveness (standardized coefficient = 0.406, p < 0.001). There is a negative correlation between coping effectiveness and impulsive behavior (standardized coefficient = -0.476, p < 0.001). The positive impact of mindfulness on impulsive behavior (standardized coefficient = -0.371, p < 0.01) is mediated by self-reflection and coping effectiveness. The explanatory power of this study is R2 = 0.35. Discussion: Mindfulness reduces impulsive behavior by enhancing self-reflection capabilities and improving coping effectiveness. Based on these substantive research results, to mitigate impulsive behavior in athletes, it is recommended that the National Sports Administration and coaches actively implement mindfulness training. Additionally, targeted psychological intervention strategies should be developed to enhance athletes' mental health levels and optimize their sports performance.

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.

The effects of expected and unexpected stress on inappropriate aggression in simulated police interventions.

Here we performed a before-after ABA-design study in police cadets (N = 82) to compare the effects of unexpected (event-triggered) and expected (anticipatory) stressors on aggression. On the first day of the study, participants filled in the Buss-Perry Aggression Questionnaire (BPAQ) and the Barratt Impulsiveness Scale (BIS) and were fitted with heart rate (HR) monitors, which remained attached till the end of the study. On day 2, they were instructed to perform a police intervention in a realistic training environment. The intervention was preceded either by a warning or by a reassuring audio recording that forecasted violent or routine interventions, respectively. Both groups encountered hostile suspects at the intervention site, the behavior of which, however, did not justify the use of force e.g., aggression. The warning resulted in a gradually developing anticipatory stress as shown by HRs. Cadets exposed to the reassuring audio recording showed minimal anticipatory stress but responded to the hostile suspects by an abrupt increase in HRs, which was missing in the warned group. The magnitude of HR responses was similar in the two groups, only their temporal evolution differed. Although aggression showed some associations with BPAQ and BIS scores, the main predictors of behavior were HR changes according to a Multiple Regression analysis. The gradually developing anticipatory stress was associated with low, whereas the abrupt increase in HRs was associated with high aggression. Our findings suggest that the anticipation of a stressful event improves behavioral control whereas an unexpected stress strongly promotes aggression.

Impulsivity and Risk-Taking Behavior in School-Going Adolescents.

Introduction Impulsivity (or impulsiveness) and risk-taking behavior are significant concerns as the adolescent population is at a higher risk of injuries and violence, unhealthy sexual behaviors, and drug- and alcohol-related problems. The early identification of these traits in adolescents can prove beneficial through timely interventions. This study was conducted to assess impulsive behavior and risk-taking behavior among school-going adolescents in New Delhi, India, and to study the association, if any, between the two. Methodology A cross-sectional study was conducted among 571 students of classes 9th-10th in three randomly selected schools in a part of Delhi, India. Barratt Impulsiveness Scale - Brief (BIS-Brief) was used to evaluate impulsivity, and risk-taking behavior was assessed using the RT-18 tool. Results The majority (72.3%) of the 571 students were aged 14-15 years. Among the students, 56.0% were males. The impulsivity score obtained ranged from 8 to 30, with a mean score of 15.7 (SD ±4.1). The risk-taking score ranged from 2 to 18, with a mean score of 9.9 (SD ±2.9). Impulsivity was seen to be significantly higher among the female students (p=0.004). The risk-taking behavior was significantly higher among the students from government schools, among the females, and among those who used the internet more. There was a significant direct association between impulsivity and risk-taking behavior among the students (correlation coefficient 0.301, p<0.001). Conclusion The study results showed that the mean impulsivity and risk-taking scores were comparable to other studies in adolescent age groups done internationally using the same tools. Impulsivity and risk-taking behavior were both found to be higher among females. There was a significant direct association between impulsivity and risk-taking.

Potential risk and protective factors related to problematic social media use among adolescents in Iran: A latent profile analysis.

This study aimed to assess Problematic Social Media Use (PSMU) among Iranian adolescents and explore potential risk and protective factors. In the present cross-sectional study, 3375 Iranian adolescents were recruited online and completed questionnaires. Latent profile analysis (LPA) was performed to identify groups with various levels of PSMU. Indicator variables included standardized factor scores for PSMU, attention-deficit/hyperactivity disorder, sensation-seeking, internet addiction, loneliness, social anxiety, internalizing symptoms, social support and self-esteem. Five groups were identified relating to severities of PSMU and other factors: low-risk: n = 823 (24.4 %); low-to-moderate-risk: n = 835 (24.7 %); moderate-risk: n = 630 (18.7 %); moderate-to-high-risk: n = 584 (17.3 %); high-risk: n = 503 (14.9 %). Multiple factors, including sensation-seeking, internalizing symptoms, social anxiety, loneliness, internet addiction, attention-deficit/hyperactivity disorder, low self-esteem and low perceived social support, statistically predicted PSMU. The current findings may help identify Iranian adolescents who are particularly vulnerable to PSMU and assist in intervention development.

Impulsive choice in individuals with comorbid amphetamine use disorder and attention deficit-hyperactivity disorder.

BACKGROUND: Amphetamine use disorder (AMPH) and attention deficit-hyperactivity disorder (ADHD) often co-occur and are associated with poor treatment outcomes. Elevated impulsivity is a core feature in both disorders. Little is known however about the specific neurocognitive profile regarding different facets of impulsivity, and specifically impulsive choice, in comorbid populations. METHODS: Three groups (ADHD + AMPH, ADHD only and healthy controls (HC)) were assessed with self-reported impulsivity and cognitive tasks of impulsive choice, operationalized as delay aversion (DA) and reflection impulsivity. RESULTS: Twenty-nine participants with comorbid ADHD + AMPH, 25 participants with ADHD only and 116 HC completed screening, including self-rating scales, and cognitive testing. 20, 16 and 114 participants completed computerized cognitive tasks in the ADHD + AMPH group, ADHD group and HC group, respectively. The ADHD + AMPH group reported significantly higher motor, attentional and non-planning impulsiveness, and showed a significantly higher degree of impulsive choice, compared to both groups. There were no differences in task-related impulsiveness between ADHD only and HC. CONCLUSIONS: The current findings suggest that individuals with ADHD + AMPH have overall elevated levels of impulsivity compared to individuals with ADHD only. In addition, that ADHD + AMPH is specifically associated with impairments in task-related impulsive choice, which was not found in ADHD only compared to HC. The neurocognitive profile in this specific patient group may represent a need for more systematic screening within healthcare settings in order to develop effective and targeted treatment for comorbid patients. TRIAL REGISTRATION: EudraCT, 2012-004298-20.

Mouse-cursor trajectories reveal reduced contextual influence on decision conflict during delay discounting in anorexia nervosa.

OBJECTIVE: The capacity of individuals with anorexia nervosa (AN) to forgo immediate food rewards in their long-term pursuit of thinness is thought to reflect elevated self-control and/or abnormal reward sensitivity. Prior research attempted to capture an increased tendency to delay gratification in AN using delay-discounting tasks that assess how rapidly the subjective value of rewards decreases as a function of time until receipt. However, significant effects were mostly subtle or absent. Here, we tested whether the process leading to such decisions might be altered in AN. METHOD: We recorded mouse-cursor movement trajectories leading to the final choice in a computerized delay-discounting task (238 trials) in 55 acutely underweight females with AN and pairwise age-matched female healthy controls (HC). We tested for group differences in deviations from a direct choice path, a measure of conflict strength in decision making, and whether group moderated the effect of several predictors of conflict strength (e.g., choice difficulty, consistency). We also explored reaction times and changes in trajectory directions (X-flips). RESULTS: No group differences in delay-discounting parameters or movement trajectories were detected. However, the effect of the aforementioned predictors on deviations (and to a lesser extent reaction times) was reduced in AN. DISCUSSION: These findings suggest that while delay discounting and conflict strength in decision making are generally unaltered in AN, conflict strength was more stable across different decisions in the disorder. This might enable individuals with AN to pursue (maladaptive) long-term body-weight goals, because particularly conflicting choices may not be experienced as such. PUBLIC SIGNIFICANCE: The deviations from a direct path of mouse-cursor movements during a computerized delay-discounting task varied less in people with anorexia nervosa. Assuming such deviations measure decision conflict, we speculate that this increased stability might help people with anorexia nervosa achieve their long-term weight goals, as for them the struggle with the decision to eat high-calorie meals when hungry will be milder, so they would be more likely to skip them.

Chronically homeless veterans with gambling disorder: Epidemiology, clinical correlates, and traumatic experiences.

BACKGROUND: Gambling disorder (GD) is often a concern for people living in poverty. Although GD has been correlated with homelessness, there has been no study of factors related to chronic homelessness among veterans with GD. METHOD: This study used data from specialized homeless programs from the U.S. Department of Veterans Affairs Homeless Operations Management System to explore prevalence and correlates of chronic homelessness among veterans with GD in this program and to describe initial descriptive epidemiology. Chi-square tests, analyses of variance, and logistic regressions were conducted to examine differences in sociodemographic, military, clinical, and behavioral characteristics between veterans with versus without chronic homelessness. RESULT: Of 6053 veterans with GD, 1733 (28.6%) had chronic homelessness. Veterans with versus without chronic homelessness were more likely to be older, male, unemployed, and of low educational attainment and report having spent fewer years in the military. Chronic homelessness was associated with elevated odds of mental health and medical diagnoses, traumatic experiences, incarceration, and suicidal thoughts. Veterans with versus without chronic homelessness more frequently reported needing substance use, medical and psychiatric treatments but expressed low interest in participation in psychiatric treatment. CONCLUSION: Veterans with GD and chronic homelessness have more clinical and behavioral concerns and needs for treatment, but participate in treatment at lower rates. It may be important to address both chronic homelessness and GD concurrently in order to effectively support veterans facing these challenges.

A systematic review and meta-analysis of risky decision-making in specific domains of problematic use of the internet: Evidence across different decision-making tasks.

This systematic review summarizes empirical evidence on risky decision-making (objective risk and ambiguity) in specific domains of problematic use of the internet (PUI) focusing on online addictive behaviors. We conducted a pre-registered (PROSPERO: CRD42020188452) PubMed search for PUI domains: gaming, social-network use, online buying-shopping, online pornography use, and unspecified PUI. We used the Newcastle-Ottawa Scale for quality assessment. Relevant studies were identified only for gaming (n = 19), social-network use (n = 8), unspecified PUI (n = 7), and online gambling (n = 1). The meta-analyses included 25 studies (2498 participants) comparing PUI and control groups regarding decision-making performance under objective risk and ambiguity. Across PUI domains, individuals with PUI compared to control participants showed more disadvantageous decision-making in measures of objective risk (g = -0.42 [-0.69, -0.16], p = .002) but not ambiguity (g = -0.22 [-0.47, -0.04], p = .096). PUI domain and gender were significant moderators. In the risk domain, effects were particularly present in gaming disorder, especially in exclusively male samples. Overall, the paucity of empirical studies in the considered area necessitates further research to identify probable gender- and disorder-specific cognitive relationships.

Aggressive behavior and prognosis in patients with mild cognitive impairment.

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.

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.

Study on correlations of BDNF, PI3K, AKT and CREB levels with depressive emotion and impulsive behaviors in drug-naïve patients with first-episode schizophrenia.

BACKGROUND: The pathogenesis of schizophrenia is still unknown. Nearly a half of schizophrenic patients have depressive symptoms and even some impulsive behaviors. The definite diagnosis of schizophrenia is an immense challenge. Molecular biology plays an essential role in the research on the pathogenesis of schizophrenia. OBJECTIVE: This study aims to analyze the correlations of serum protein factor levels with depressive emotion and impulsive behaviors in drug-naïve patients with first-episode schizophrenia. METHODS: Seventy drug-naïve patients with first-episode schizophrenia and sixty-nine healthy volunteers from the health check center in the same period participated in this study. In both the patient group and control group, brain-derived neurotrophic factor (BDNF), phosphatidylin-ositol-3-kinase (PI3K), protein kinase B (AKT), and cAMP-response element binding protein (CREB) levels in the peripheral blood were tested by enzyme-linked immunosorbent assay (ELISA). The depressive emotion and impulsive behaviors were evaluated with Chinese versions of the Calgary Depression Scale for Schizophrenia (CDSS) and Short UPPS-P Impulsive Behavior Scale (S-UPPS-P), respectively. RESULTS: The serum levels of BDNF, PI3K, and CREB in the patient group were lower than those in the control group, while AKT level, total CDSS score and total S-UPPS-P score were all higher. In the patient group, total CDSS score, and total S-UPPS-P score were both correlated negatively with BDNF, PI3K, and CREB levels but positively with AKT level, and the lack-of-premeditation (PR) sub-scale score was not significantly correlated with BDNF, PI3K, AKT, and CREB levels. CONCLUSION: Our study results showed that the peripheral blood levels of BDNF, PI3K, AKT, and CREB in drug-naïve patients with first-episode schizophrenia were significantly different from those in the control group. The levels of these serum protein factors are promising biomarkers to predict schizophrenic depression and impulsive behaviors.