Bayard S, Joly E, Ghisletta P, Rossignol A, Herades Y, Geny C, Gély-Nargeot M-C, Rochat L
Laboratoire Epsylon,EA 4556,Universités Paul Valéry,Montpellier,France.
Methodology and Data Analysis Unit,University of Geneva,Geneva,Switzerland.
Psychol Med. 2016 Oct;46(14):2931-2941. doi: 10.1017/S0033291716001586. Epub 2016 Jul 27.
Poor impulse control is a common feature in patients with Parkinson's disease (PD). However, before testing whether patients with PD and controls differ in impulsivity, one must assess whether impulsivity measures are invariant across groups. Consequently, we examined (a) the measurement and structural invariance of a scale assessing changes in four dimensions of impulsivity (urgency, lack of premeditation, lack of perseverance and sensation seeking) among patients with PD and controls; and (b) whether the four impulsivity traits relate differentially to risky decisions by patients.
Close relatives of 78 patients with idiopathic PD and 96 control participants were given the short Urgency-Premeditation-Perseverance-Sensation seeking Impulsive Behaviour Scale (UPPS), which assesses changes in four dimensions of impulsivity. Participants also completed the Game of Dice Task (GDT), a laboratory measure of risk taking.
Multigroup confirmatory factor analyses supported measurement invariance across groups, whereas structural invariance was not confirmed. Patients with PD showed greater variability and higher impulsivity than controls. Furthermore, patients with impulse control disorders (ICDs) demonstrated even greater levels of sensation seeking than patients without ICDs. Finally, lower premeditation and greater perseverance were significantly associated with greater risk taking in patients with PD, and higher agonist dopaminergic doses with less risky choices on the GDT.
The questionnaire appears to function comparably across patients and controls. Thus, group comparisons on the questionnaire can be considered valid. Mean differences between groups on the dimensions of impulsivity may reflect executive impairments and/or abnormal reward processing in patients with PD, which may lead to risky behaviours.
冲动控制能力差是帕金森病（PD）患者的常见特征。然而，在测试PD患者和对照组在冲动性方面是否存在差异之前，必须评估冲动性测量指标在不同组间是否具有不变性。因此，我们研究了：（a）一种评估冲动性四个维度（紧迫性、缺乏预谋、缺乏毅力和寻求刺激）变化的量表在PD患者和对照组中的测量不变性和结构不变性；（b）这四个冲动性特征与患者风险决策的差异关系。
对78例特发性PD患者和96名对照参与者的近亲发放了简短的冲动行为量表（UPPS），该量表评估冲动性的四个维度。参与者还完成了掷骰子任务（GDT），这是一种实验室风险承担测量方法。
多组验证性因素分析支持了不同组间的测量不变性，但未证实结构不变性。PD患者比对照组表现出更大的变异性和更高的冲动性。此外，患有冲动控制障碍（ICD）的患者比没有ICD的患者表现出更高水平的寻求刺激。最后，在PD患者中，较低的预谋性和较高的毅力与更大的风险承担显著相关，而较高剂量的激动剂多巴胺能药物与GDT上风险较小的选择相关。
该问卷在患者和对照组中的功能似乎相当。因此，可以认为问卷上的组间比较是有效的。冲动性维度上的组间平均差异可能反映了PD患者的执行功能障碍和/或异常的奖赏处理，这可能导致危险行为。
