Swann Alan C, Bjork James M, Moeller F Gerard, Dougherty Donald M
Department of Psychiatry, University of Texas Medical School, Houston, Texas, USA.
Biol Psychiatry. 2002 Jun 15;51(12):988-94. doi: 10.1016/s0006-3223(01)01357-9.
Impulsivity is prominent in psychiatric disorders. Two dominant models of impulsivity are the reward-discounting model, where impulsivity is defined as inability to wait for a larger reward, and the rapid-response model, where impulsivity is defined as responding without adequate assessment of context. We have compared the role of these models of impulsivity in human psychopathology, based on the hypothesis that rapid-response impulsivity would be more strongly related to other aspects of psychopathology and to impulsivity as described by questionnaires.
We investigated relationships between personality and laboratory measures of impulsivity, and between these measures and clinical characteristics, in parents of adolescent subjects with disruptive behavioral disorders (DBDs) and matched control subjects. Diagnoses were rendered using the Structured Interview for DSM-IV. The Barratt Impulsiveness Scale (BIS) was used as a trait measure of impulsivity. Rapid-response impulsivity was assessed using a form of the Continuous Performance Test, the Immediate Memory-Delayed Memory Task (IMT/DMT). Reward-delay impulsivity was measured using two tasks where subjects could choose between smaller immediate or larger delayed rewards.
Rapid-response, but not reward-delay impulsivity, was significantly higher in subjects with lifetime Axis I or Axis II diagnoses. Scores on the BIS were elevated in subjects with Axis I diagnoses and correlated significantly with both rapid-response and reward-delay tests, but more strongly with the former. Multiple regression showed that rapid-response, but not reward-delay performance or intelligence quotient, contributed significantly to BIS scores. Correlations were similar in parents of control subjects and of DBD subjects.
These data suggest that measures of rapid-response impulsivity and of reward-delay impulsivity are both related to impulsivity as a personality characteristic. The relationship appears stronger, however, for rapid-response impulsivity, as measured by the IMT/DMT. Laboratory and personality measures of impulsivity appear to be related to risk of psychopathology.
冲动性在精神疾病中较为突出。冲动性的两种主要模型是奖励折扣模型，其中冲动性被定义为无法等待更大的奖励；以及快速反应模型，其中冲动性被定义为在没有充分评估情境的情况下做出反应。基于快速反应冲动性与精神病理学的其他方面以及问卷所描述的冲动性之间的关系更为密切这一假设，我们比较了这些冲动性模型在人类精神病理学中的作用。
我们调查了患有破坏性行为障碍（DBD）的青少年受试者的父母和匹配的对照受试者的人格与冲动性的实验室测量之间的关系，以及这些测量与临床特征之间的关系。使用《精神疾病诊断与统计手册》第四版（DSM-IV）的结构化访谈进行诊断。使用巴拉特冲动性量表（BIS）作为冲动性的特质测量。使用连续性能测试的一种形式，即即时记忆-延迟记忆任务（IMT/DMT）来评估快速反应冲动性。使用两个任务来测量奖励延迟冲动性，在这两个任务中，受试者可以在较小的即时奖励或较大的延迟奖励之间进行选择。
有终生轴I或轴II诊断的受试者中，快速反应冲动性显著更高，而奖励延迟冲动性则不然。轴I诊断的受试者的BIS得分升高，并且与快速反应和奖励延迟测试均显著相关，但与前者的相关性更强。多元回归表明，快速反应，而非奖励延迟表现或智商，对BIS得分有显著贡献。对照受试者和DBD受试者的父母中的相关性相似。
这些数据表明，快速反应冲动性测量和奖励延迟冲动性测量均与作为人格特征的冲动性相关。然而，通过IMT/DMT测量的快速反应冲动性的关系似乎更强。冲动性的实验室和人格测量似乎与精神病理学风险相关。
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