青年成人精神疾病中的冲动性。
Impulsivity across psychiatric disorders in young adults.
作者信息
Crisp Zharia C, Grant Jon E
机构信息
Pritzker School of Medicine, University of Chicago, Chicago, IL, USA.
Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, IL, USA.
出版信息
Compr Psychiatry. 2024 Apr;130:152449. doi: 10.1016/j.comppsych.2023.152449. Epub 2024 Jan 4.
PURPOSE
Impulsivity is a common cognitive issue across several psychiatric illnesses but is most frequently associated with the DSM-5 Disruptive, Impulse Control and Conduct Disorders, ADHD, and addictive disorders. We hypothesized that a wide range of psychiatric disorders would be associated with elevated impulsivity, not just those commonly linked to impulsiveness. This study aimed to explore the relationship between impulsivity and various psychiatric disorders in young adults.
PROCEDURES
700 non-treatment seeking participants (aged 18-29 years) were enrolled from the general community, provided demographic information, and underwent a psychiatric evaluation to screen for various psychiatric disorders. Each participant then completed the Barratt Impulsiveness Scale (BIS), a self-report measure of impulsivity, followed by the Stop Signal Task (SST), a computerized stop-attention task that measures impulse control. Impulsivity levels across psychiatric disorders were examined by analyzing z-scores relative to controls.
MAIN FINDINGS
Patients with bulimia nervosa, comorbid panic disorder with agoraphobia, and borderline personality disorder showed the highest levels of attentional, motor, and non-planning impulsivity, respectively. The effect size of the difference in total BIS impulsivity was large (d > 0.8) for several conditions including eating, personality, addictive, and mood disorders. The effect size of the difference in impulsivity was not large for any of the measures of ADHD. As compared to other psychiatric disorders analyzed, trichotillomania showed the greatest levels of impulsivity as measured by SST.
PRINCIPAL CONCLUSIONS
This data indicates that a wide range of psychiatric disorders exhibit heightened impulsivity with findings differing across various cognitive domains. Comorbidity resulted in unique findings of elevated impulsivity. This may suggest utility in viewing impulsivity as a transdiagnostic factor for a broad range of psychiatric disorders. Future studies should analyze comorbidities and whether patient psychiatric medication impacts these findings.
目的
冲动性是多种精神疾病中常见的认知问题,但最常与《精神疾病诊断与统计手册》第五版(DSM - 5)中的破坏性行为、冲动控制及品行障碍、注意力缺陷多动障碍(ADHD)和成瘾性障碍相关。我们假设,不仅是那些通常与冲动性相关的疾病,广泛的精神疾病都可能与冲动性升高有关。本研究旨在探讨冲动性与年轻成年人中各种精神疾病之间的关系。
程序
从普通社区招募了700名未寻求治疗的参与者(年龄在18 - 29岁之间),收集了人口统计学信息,并进行了精神评估以筛查各种精神疾病。然后,每位参与者完成了巴拉特冲动性量表(BIS),这是一种冲动性的自我报告测量工具,接着完成了停止信号任务(SST),这是一项测量冲动控制的计算机化停止注意任务。通过分析相对于对照组的z分数,研究了各种精神疾病中的冲动性水平。
主要发现
神经性贪食症患者、伴有广场恐惧症的共病惊恐障碍患者和边缘型人格障碍患者分别表现出最高水平的注意力、运动和非计划性冲动性。在包括饮食、人格、成瘾和情绪障碍在内的几种情况下,BIS总冲动性差异的效应量很大(d > 0.8)。对于ADHD的任何测量指标,冲动性差异的效应量都不大。与分析的其他精神疾病相比,拔毛癖在SST测量中表现出最高水平的冲动性。
主要结论
这些数据表明,广泛的精神疾病表现出冲动性增强,且在不同认知领域的结果有所不同。共病导致了冲动性升高的独特发现。这可能表明将冲动性视为广泛精神疾病的跨诊断因素具有实用性。未来的研究应分析共病情况以及患者的精神科药物是否会影响这些结果。