The developmental trajectories of executive function of children and adolescents with Attention Deficit Hyperactivity Disorder.

This study examined the developmental trajectories of executive function (EF) of children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD) in Han Chinese. Five hundred and fifteen children and adolescents with ADHD and 249 healthy controls took part in this study. All of them were administered four EF tests capturing inhibition, working memory, shifting and planning components. The participants were further divided into four age groups, 7-8, 9-10, 11-12, and 13-15 years old, respectively, for developmental trajectories comparison. The performance of the typical developing children and adolescents aged 7-15 were reported to get stable at age 11-12 for inhibition, working memory and planning, and kept developing till age 13-15 for shifting. For inhibition and shifting, participants with ADHD displayed similar performance to the healthy controls who were 2 years younger whereas they did poorer than the healthy controls of their same age. And at age 13-15, such poorer performance disappeared for inhibition but maintained for shifting. No significant differences were found between participants with and without ADHD in working memory and planning across all age groups. The current findings suggested, compared with healthy controls, Han Chinese children and adolescents with ADHD displayed delayed developmental trajectories on inhibition and shifting, whereas they showed similar trend of development on working memory and planning.

It's called "Going out to play": a video diary study of Hmong girls' perspectives on running away.

How do Hmong immigrant adolescent girls decide to run away, return home, leave again, or stay home? Video diaries by 11 sexually exploited runaway Hmong girls, ages 13-16, revealed four themes: "fighting restrictions," or resisting family and cultural expectations and desires to be like other American teens; "not running away, going out to play," which captured impulsive decision making; "unrestrained partying," which described runaway experiences but minimized the dangers faced; and "trying to change," or returning home because of family bonds and wanting to "be someone good." Given their limited ability to anticipate risks, interventions should focus on runaway prevention initiatives for Hmong families and teens.

An initial evaluation of the role of emotion and impulsivity in explaining racial/ethnic differences in the use of corporal punishment.

The authors sought to provide an initial evaluation of the hypothesis that corporal punishment is less strongly associated with parental emotion and impulsivity among African American ("Black") in contrast to European American ("White") parents. White-Latino and Black-Latino differences in corporal punishment, emotion, and impulsivity were explored, given the lack of existing theory predicting group differences. Couples with 3- to 7-year-old children were recruited via random digit dialing, and the parents completed questionnaires and an analog parent-child conflict task in the laboratory. Group differences were tested pooling mothers and fathers via dyadic data analyses. Black parents (N = 57) had more positive attitudes toward and used more corporal punishment than White parents (N = 730). Latino American parents' (N = 78) views and use of corporal punishment were similar to those of White parents. By and large, associations of corporal punishment with parents' impulsivity and emotion did not significantly vary by race/ethnicity. The present findings, although preliminary, do not support the emotion-impulsivity hypothesis of racial differences in the use of corporal punishment suggested by K. Deater-Deckard, K. A. Dodge, J. E. Bates, and G. S. Pettit (1996).

Iron-deficiency anemia in infancy and social emotional development in preschool-aged Chinese children.

OBJECTIVE: We aimed to compare affect and behavior of 3 groups of nonanemic 4-year-old children: children with iron-deficiency anemia (IDA) in infancy whose anemia was not corrected before 24 months (chronic IDA) (n = 27); children with IDA in infancy whose anemia was corrected before 24 months (corrected IDA) (n = 70); and children who were nonanemic in infancy and at 24 months (n = 64). METHOD: Mother and child dyads were invited to a local clinic room. Children's social referencing, wariness, frustration-tolerance behavior, and affect were observed during a set of situations encountered in the laboratory, including free play, stranger approach, novel toy, and delay of gratification. The whole procedure was videotaped. The children's affective and behavioral displays were coded by using a time-sampling (5-second segments) code scheme. Iron status of children was determined on the basis of hemoglobin concentration measured with the cyanomethemoglobin method in blood samples obtained by fingerstick in infancy and at the ages of 24 months and 4 years. RESULTS: Children who had chronic IDA in infancy displayed less positive affect, less frustration tolerance, more passive behavior, and more physical self-soothing in the stranger approach and delay of gratification. In contrast, the behavior and affect of children whose anemia was corrected before the age of 24 months were comparable to those of children who were nonanemic throughout infancy. CONCLUSION: The results point to the potential benefits of preventing iron deficiency in infancy and treating it before it becomes chronic or severe.

Impulsivity and the 5-HTTLPR polymorphism in a non-clinical sample.

BACKGROUND: Impulsivity has been associated with serotonergic system functions. However, few researchers have investigated the relationship between a polymorphism in the promoter of the serotonin transporter gene (5-HTTLPR) and the different components of impulsivity in a non-clinical population. The aim of this study was to investigate the relationship between a polymorphism in the promoter region of the serotonin transporter gene (5-HTTLPR) and the different components of impulsivity in a non-clinical population. METHODOLOGY/PRINCIPAL FINDINGS: We administered two neuropsychological tests, the Continuous Performance Task and the Iowa Gambling Task, to 127 healthy participants to measure their levels of motor, attentional and non-planning impulsivity. Then, these participants were grouped by genotype and gender, and their scores on impulsivity measures were compared. There were no significant differences between group scores on attentional, motor and non-planning impulsivity. CONCLUSIONS/SIGNIFICANCE: Our results suggest that 5-HTTLPR genotype is not significantly associated with subsets of impulsive behavior in a non-clinical sample when measured by neuropsychological tests. These findings are discussed in terms of the sensitivity of neuropsychological tests to detect impulsivity in a non-clinical population and the role of gender and race in the relationship between the 5-HTTLPR and impulsivity.

Unplanned versus planned suicide attempters, precipitants, methods, and an association with mental disorders in a Korea-based community sample.

BACKGROUND: Studies have consistently reported that a considerable proportion of suicidal attempts are unplanned. We have performed the first direct comparison between planned and unplanned attempts including associated methods and precipitants. METHOD: A total of 6510 adults, who had been randomly selected through a one-person-per-household method, completed interviews (response rate 81.7%). All were interviewed using the K-CIDI and a questionnaire for suicide. RESULTS: Two hundred and eight subjects reported a suicide attempt in their lifetime, one-third of which had been unplanned. These individuals exhibited a lower level of education; however, no significant differences were found with regard to age, gender, marital and economic status. Further, 84.0% of unplanned attempters experienced previous suicidal ideation, experiencing their first attempt 1.9 years before ideation. Additionally, 94.4% of unplanned attempters had precipitants for attempts such as familial conflict and it was also found that methods such as the use of chemical agents or falling were three times more common in unplanned than planned attempters. With respect to unplanned attempters, they exhibited a significant association with alcohol use disorder, major depressive disorder, posttraumatic stress disorder, and bipolar disorder. In particular, bipolar disorder was found to be 3.5 times higher in these individuals. CONCLUSIONS: Results have revealed that unplanned suicide attempters experience suicidal ideation and precipitants prior to their attempt. Further, attempts were associated with affective and alcohol use disorders. Therefore, in order to reduce the number of suicidal attempts, it may be useful to evaluate suicidal ideation concurrent to the treatment of existing mental disorders.

ADHD across cultures: is there evidence for a bidimensional organization of symptoms?

We examined the phenotypic expression of attention-deficit/hyperactivity disorder (ADHD) across cultures by assessing the factor/latent class structure of its core symptoms. We conducted a systematic review of the literature published from January 1987 to November 2008 using Medline and PsycINFO. We systematically reviewed 2,511 article abstracts, and 48 of these abstracts were included in this review. Research with school-age children from 15 countries including different samples, informants, and rating instruments supported a two-factor ADHD model consisting of inattention and combined hyperactivity and impulsivity. This model was not supported for preschool children. Cross-cultural equivalence for the two-factor model was suggested in some studies. Latent class analyses using parental data and more recent approaches like factor mixture modeling are generally consistent with factor analyses. These findings argue in favor of a cross-cultural validity of the syndrome. The implications of these findings for further research and classificatory systems in mental health like the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) are discussed.

The relationships of personal and cultural identity to adaptive and maladaptive psychosocial functioning in emerging adults.

The present study examined the extent to which cultural identity would be associated with adaptive and maladaptive psychosocial functioning, both directly and indirectly through a personal identity consolidation. A sample of 773 White, Black, and Hispanic university students completed measures of cultural identity, personal identity consolidation, adaptive psychosocial functioning, internalizing symptoms, and proclivity toward externalizing symptoms. Both heritage and American cultural identity were positively related to adaptive psychosocial functioning; American-culture identity was negatively associated with internalizing symptoms; and heritage-culture identity was negatively related to proclivity toward externalizing symptoms. All of these findings were mediated by personal identity consolidation and were fully consistent across ethnic groups. We discuss implications in terms of broadening the study of identity to include both personal and cultural dimensions of self.

Impulsive but fatal self-poisoning with pesticides among South Asians in Nickerie, Suriname.

BACKGROUND: Intentional self-poisoning with pesticides is a serious problem in many developing countries. It is a commonly used method among South Asians all over the world. AIMS: To describe the circumstances and characteristics of suicides in Nickerie, e, in order to gain insight into why South Asians commonly use self-poisoning. METHODS: An exploratory psychological autopsy study was conducted among 19 survivors of 13 suicides in the Nickerie district in Suriname. RESULTS: Impulsivity plays an important role in self-poisonings, as well as aggression and easy accessibility of pesticides. CONCLUSIONS: Possible answers to the question why South Asians often use self-poisoning as a method for suicide may be found in culture, upbringing, styles of communication and genetics. However, more research is needed to further explore these hypotheses.

Alcohol expectancies as a mediator of the relation between impulsivity and alcohol consumption in Asian Americans.

Past research on alcohol consumption in minority groups has focused on examining differences in the level of drinking. However, research has yet to fully examine racial differences in the factors that might mediate alcohol consumption. The current study sought to test whether alcohol expectancies mediated the relation of impulsivity on alcohol consumption for an Asian American sample. Participants included 57 Asian American and 70 Caucasian undergraduate students. Results showed that positive alcohol expectancies fully mediated the pathway between dimensions of impulsivity and alcohol use for Asian Americans. For Caucasian participants, only impulsivity predicted alcohol use. Future research on alcohol use and abuse by Asian Americans should consider the role of alcohol expectancies in different social contexts.

Adverse drinking-related consequences among lower income, racial, and ethnic minority drinkers: cross-sectional results.

OBJECTIVE: To examine factors associated with adverse consequences of alcohol consumption among a community sample of drinkers in a low-income, racial, and ethnic minority community. METHODS: A sample of 329 drinkers was recruited from 17 randomly selected off-sell alcohol outlets in South Los Angeles. Respondents were interviewed by trained research personnel on their demographic characteristics, income, drinking patterns and preferences, and alcohol-related adverse consequences (using the Drinkers Inventory of Consequences--DrInC), among other items. We developed logistic regression models predicting high scores on DrInC total score and subscales (impulse control, interpersonal, intrapersonal, physical, and social responsibility). RESULTS: In this sample, we found drinking patterns--bingeing, drinking outdoors, drinking in the morning--to be significantly associated with total DrInC scores and some subscales. Malt liquor beverage (MLB) use was significantly associated with total DrInC score and interpersonal and social responsibility subscales. Previous alcohol treatment predicted all but 1 DrInC subscale and total score. CONCLUSIONS: A diverse array of factors predicted high DrInC total and subscale scores. More research on the association between MLB use and consequences is required. In addition, studies with community samples are likely to further enrich our understanding of the interactions between drinking patterns and preferences, settings, and negative consequences.

Moral objections to suicide and suicidal ideation among mood disordered Whites, Blacks, and Hispanics.

UNLABELLED: Understanding the beliefs that protect individuals against suicide can help to enhance suicide prevention strategies. One measure of suicide non-acceptability is the moral objections to suicide (MOS) sub-scale of the reasons for living inventory (RFLI). This study examined the MOS and suicidal ideation of White, Black, and Hispanic individuals with mood disorders. We expected minority individuals to have stronger objections to suicide. METHOD: Eight hundred and four, White (588), Black (122) and Hispanic (94) participants with DSM-IV diagnoses of MDD or bipolar disorder were administered the scale for suicide ideation, the reasons for living inventory and several measures of clinical distress. RESULTS: Higher suicidal ideation was modestly correlated with lower MOS scores overall (r=0.15, p=0.001). Among Blacks however the relationship was inverted: despite having higher suicidal ideation than Whites or Hispanics, Blacks reported the least accepting attitudes toward suicide. CONCLUSION: These results suggest that attitudes regarding the acceptability of suicide may be independent of suicidal ideation.

Ethnic variations in the structure of borderline personality disorder symptomatology.

The goal of this study was to examine differences in the factor structure of borderline personality disorder symptoms among different ethnic groups. The authors obtained information regarding ethnic identity and endorsement of borderline personality disorder criteria for an ethnically diverse community sample of 1140 young adult subjects from south Florida. Using this information the authors conducted an exploratory factor analysis examining differences between Caucasian, Hispanic and African American groups. A principal-components factor analysis (PCA) with Varimax rotation for each ethnic group revealed a reasonably generalizable four-factor structure: affective dysregulation, cognitive disturbance, disturbed relatedness and behavioral dysregulation. The emergence of a four-factor structure across three separate, relatively large samples suggests that the factors obtained have merit. However, the loadings of some BPD symptoms, such as impulsivity, varied for each ethnic group. The results of this study indicate that ethnic variations in borderline personality disorder should be considered during assessment and treatment of this disorder. Also, future research should examine if this same factor structure holds for ethnic minorities with BPD diagnoses, examine ethnic differences in the etiology and maintenance of BPD symptomatology, and explore the effects that these differences might have in treatment settings.

Impulsivity in Hong Kong-Chinese club-drug users.

To investigate the relationship between personality, club-drug use and high-risk drug-related behaviour, 360 club-drug users and 303 non-drug users in Hong Kong were assessed on measures of two impulsivity dimensions, reward drive and rash impulsivity, and a related trait of punishment sensitivity. The most frequently used drugs were ketamine, ecstasy, and cannabis, with the majority of participants using two or more drugs on any one occasion. Club-drug users were more rash-impulsive and reward-driven, and less punishment-sensitive than non-drug users (p<0.001). Rash impulsivity, but not reward drive or punishment sensitivity, was significantly (p<0.001) associated with risky drug-related behaviour. There was no association between any personality traits and preferred drug. These findings suggest that, while those who use club drugs are generally more impulsive and less punishment-sensitive, some discrete facets of impulsivity are associated with differing patterns of drug-use behaviour.

Sensation seeking and risk-taking propensity as mediators in the relationship between childhood abuse and HIV-related risk behavior.

OBJECTIVES: Although a wealth of literature suggests that childhood physical, emotional, and sexual abuse are related to later-life HIV-related risk behaviors, few studies have explored disinhibition (e.g., impulsivity, risk-taking propensity, and sensation-seeking) as a risk factor in this relationship. METHOD: This cross-sectional study examined impulsivity, risk-taking propensity, and sensation seeking as mediators in the relationship between abuse history and engagement in HIV-related risk behaviors among a sample of 96 inner-city African American adolescents. RESULTS: Findings indicated that abuse history was positively related to self-reported engagement in HIV-related risk behaviors (B=.027, SE .008, beta=.32, sr(2)=.105, p=.001), as well as risk-taking propensity (B=.35, SE .11, beta=.30, sr(2)=.090, p=.003) and sensation seeking (B=.17, SE .05, beta=.35, sr(2)=.124, p=.0004). Abuse history was not related to impulsivity. Further, while sensation-seeking and risk-taking propensity (to a lesser extent) mediated this relationship, impulsivity did not. CONCLUSIONS: These findings provide an initial step in the examination of the mechanisms underlying the relationship between childhood abuse and engagement in HIV-related risk behaviors.

Impulsivity, anger, and psychopathy: the moderating effect of ethnicity.

The present research tested the four-factor Psychopathy Checklist: Screening Version (PCL:SV) latent variable model for structural invariance across ethnicity in a large sample of civil psychiatric patients. In addition, it also examined how Barratt (1994) impulsivity and Novaco (1994) anger latent variables were related to the psychopathy dimensions within and across ethnicity. The data were analyzed with Mplus (Muthen & Muthen, 2001), and results indicated that the four-factor model was invariant across Caucasian and African American males in terms of both item factor loadings and thresholds. However, differential relations between the external correlates and the psychopathy dimensions were found across groups, suggesting that the association between impulsivity and psychopathy may be moderated by ethnicity.

The human protein kinase C gamma gene (PRKCG) as a susceptibility locus for behavioral disinhibition.

This study explores the association between a highly heritable behavioral disinhibition phenotype and the protein kinase C gamma (PRKCG) gene in an ethnically diverse youth sample from Colorado, USA. The rationale for this study was based on the impulsive behavior and increased ethanol consumption observed in the protein kinase C gamma (PKC-gamma)-deficient mouse model. Two composite behavioral disinhibition phenotypes and their component behavioral scores [conduct disorder, attention-deficit hyperactivity disorder (ADHD), substance experimentation (SUB) and novelty-seeking] were examined for association with five independent PRKCG single nucleotide polymorphisms (SNPs). Association analysis for the five individual SNPs revealed modest genetic association of Exon 14 (rs2242244) and Upstream (rs307941) markers with the behavioral disinhibition composite variables in the combined, Hispanic and African-American samples. Additionally, haplotype-based association analysis for two SNPs located in Intron 3 (rs402691) and Exon 6 (rs3745406) indicated a significant overall association of the PRKCG locus with the ADHD-hyperactive subscale scores in the combined and Caucasian samples, supporting the relation between impulsive behaviors and the PRKCG gene. A significant haplotype association was also observed with SUB scores but only in the Hispanic ethnic group, highlighting the marker variability for each ethnic group. In conclusion, our results support the role of the PKC-gamma enzyme in behavioral impulsivity previously observed in mice. This study provides the first exploration of the PRKCG gene and its association with behavioral disinhibition and warrants further study in other larger population samples.

Relations of effortful control, reactive undercontrol, and anger to Chinese children's adjustment.

The purpose of the study was to examine the zero-order and unique relations of effortful attentional and behavioral regulation, reactive impulsivity, and anger/frustration to Chinese first and second graders' internalizing and externalizing symptoms, as well as the prediction of adjustment from the interaction of anger/frustration and effortful control or impulsivity. A parent and teacher reported on children's anger/frustration, effortful control, and impulsivity. Parents reported on children's internalizing symptoms, and teachers and peers reported on children's externalizing symptoms. Children were classified as relatively high on externalizing (or comorbid), internalizing, or nondisordered. High impulsivity and teacher-reported anger/frustration, and low effortful control, were associated with externalizing problems, whereas low effortful control and high parent-reported anger were predictive of internalizing problems. Unique prediction from effortful and reactive control was obtained and these predictors (especially when reported by teachers) often interacted with anger/frustration when predicting problem behavior classification.

Self-reported psychotic symptoms predict impulsivity among African-American patients in an urban non-psychiatric medical setting.

A variety of epidemiological studies have documented self-reported psychotic symptoms among individuals in the general population. Research has not been conducted on the associations between self-reported psychotic symptoms and enduring personality characteristics, such as impulsivity, among participants in non-psychiatric settings. We hypothesized that impulsivity scores, as measured by the Barratt Impulsiveness Scale (BIS-11), would be predicted partly by the presence of one or more of a variety of positive psychotic experiences, determined by the revised Symptom Checklist-90. The sample consisted of 100 African-American men and women seeking care in medical clinics in an urban public sector hospital. The sample was divided into those participants endorsing one or more of six psychotic symptoms and those not reporting psychotic symptoms. Multiple linear regression models examined predictors of impulsivity (as measured by the BIS-11 total score and the two derived subscales), including the effect of self-reported positive psychotic symptoms. The presence of psychotic symptoms was predictive of the total impulsivity score and the ideo-motor impulsivity subscale score, even after adjustment for the effects of other correlates of impulsivity, including gender, homelessness, history of conviction for a misdemeanor or felony, and history of past treatment or hospitalization for psychiatric or substance abuse problems. The findings suggest that there is an important link between the presence of self-reported psychotic symptoms and impulsivity, especially ideo-motor impulsivity, in a general sample of low-income African-American men and women seeking ambulatory medical care. Further research on self-reported psychotic symptoms in non-psychiatric populations is needed, as well as research on the personality correlates of such symptoms, including impulsivity.

Pre-treatment measures of impulsivity, aggression and sensation seeking are associated with treatment outcome for African-American cocaine-dependent patients.

We investigated whether measures of impulsivity, aggression and sensation seeking differed between cocaine-dependent subjects and controls, and whether these measures were related to treatment-outcome for cocaine patients. Pre-treatment assessments of impulsivity (Barratt Impulsivity Scale [BIS]), aggression (Buss-Durkee Hostility Inventory [BDHI]) and sensation seeking (Zuckerman Sensation Seeking Scale [SSS]) were obtained for 141 African-American cocaine-dependent patients entering a 12-week, intensive outpatient treatment program and 60 controls. The outcome measures were number of negative urine drug screens, days in treatment, dropout rates and number of treatment sessions. Cocaine patients reported significantly higher scores on the SSS, the BIS and the BDHI than controls. Furthermore, the SSS scores showed a significantly negative correlation with days in treatment and negative urines, and a significant positive correlation with the dropout rate. The BIS and the BDHI scores were significantly associated with days in treatment and dropout rates respectively. A combination of the three variables contributed significantly toward predicting retention and abstinence. Higher levels of pretreatment impulsivity and aggression and sensation seeking seem to associated with poor treatment outcome for cocaine dependent patients receiving intensive outpatient treatment. Combining these behavioral measures with other clinical predictors may help in early identification of 'poor responders' who may benefit from additional or alternative treatment approaches.