The high comorbidity of impulsivity and selected psychiatric disorders, including personality disorders, substance use disorders, and bipolar disorder, is in a large part related to the association between impulsivity and the biological substrates of these disorders. Before treatment studies on impulsivity can move forward, measures of impulsivity that capture the core aspects of this behavior need to be refined and tested on the basis of an ideologically neutral model of impulsivity.

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An essential component of the human diet, L-tryptophan is critical in a number of metabolic functions and has been widely used in numerous research and clinical trials. This review provides a brief overview of the role of L-tryptophan in protein synthesis and a number of other metabolic functions. With emphasis on L-tryptophan’s role in synthesis of brain serotonin, details are provided on the research uses of L-tryptophan, particularly L-tryptophan depletion, and on clinical trials that have been conducted using L-tryptophan supplementation. The ability to change the rates of serotonin synthesis in the brain by manipulating concentrations of serum tryptophan is the foundation of much research. As the sole precursor of serotonin, experimental research has shown that L-tryptophan’s role in brain serotonin synthesis is an important factor involved in mood, behavior, and cognition. Furthermore, clinical trials have provided some initial evidence of L-tryptophan’s efficacy for treatment of psychiatric disorders, particularly when used in combination with other therapeutic agents.

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These results suggest that a history of severe suicidal behavior in patients with bipolar disorder is associated with impulsivity, manifested as a tendency toward rapid, unplanned responses.

Twin, adoption, and family studies have established the heritability of suicide attempts and suicide. Identifying specific suicide diathesis-related genes has proven more difficult. As with psychiatric disorders in general, methodological difficulties include complexity of the phenotype for suicidal behavior and distinguishing suicide diathesis-related genes from genes associated with mood disorders and other suicide-associated psychiatric illness. Adopting an endophenotype approach involving identification of genes associated with heritable intermediate phenotypes, including biological and/or behavioral markers more proximal to genes, is an approach being used for other psychiatric disorders. Therefore, a workshop convened by the American Foundation for Suicide Prevention, the Department of Psychiatry at Columbia University, and the National Institute of Mental Health sought to identify potential target endophenotypes for genetic studies of suicidal behavior. The most promising endophenotypes were trait aggression/impulsivity, early-onset major depression, neurocognitive function, and cortisol social stress response. Other candidate endophenotypes requiring further investigation include serotonergic neurotransmission, second messenger systems, and borderline personality disorder traits.

Previous research and theory have conceptualized impulsivity as a multifaceted construct that requires multiple modes of measurement for accurate assessment. This article describes a software package that includes four paradigms for measuring multiple and unique aspects of impulsivity. Specifically, four tasks are described: (1) the two choice impulsivity paradigm, (2) the single key impulsivity paradigm, (3) the GoStop impulsivity paradigm, and (4) the time paradigm. These tasks measure processes related to the capacity to tolerate delay for reward, to inhibit an already initiated response, and to estimate the passage of time. These processes have been found to be important to the understanding of impulsive behaviors. The programs are flexible and allow the experimenter to manipulate a number of parameters related to delay-reward contingencies, timing, performance feedback/payment, and data output variables. Manipulation of these parameters makes the paradigms scalable to a wide range of ability levels and appropriate for samples ranging from children to adults. The four paradigms in this software package are available at no cost and can be obtained by contacting the corresponding author.

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