Risky and excessive behaviors, such as aggressive and compulsive behaviors, are frequently described in patients with brain damage and have dramatic psychosocial consequences. Although there is strong evidence that impulsivity constitutes a key factor at play in these behaviors, the literature about impulsivity in neuropsychology is to date scarce. In addition, examining and understanding these problematic behaviors requires the assumption that impulsivity is a multidimensional construct. Consequently, this article aims at shedding light on frequent risky and excessive behaviors in patients with brain damage by focusing on a unified, comprehensive, and well-validated model, namely, the UPPS model of impulsivity. This model considers impulsivity as a multidimensional construct that includes four facets: urgency, (lack of) premeditation, (lack of) perseverance, and sensation seeking. Furthermore, we discuss the psychological mechanisms underlying the dimensions of impulsivity, as well as the laboratory tasks designed to assess each mechanism and their neural bases. We then present a scale specifically designed to assess these four dimensions of impulsivity in patients with brain damage and examine the data regarding this multidimensional approach to impulsivity in neuropsychology. This review supports the need to adopt a multifactorial and integrative approach toward impulsive behaviors, and the model presented provides a valuable rationale to disentangle the nature of brain systems and mechanisms underlying impulsive behaviors in patients with brain damage. It may also foster further relevant research in the field of impulsivity and improve assessment and rehabilitation of impulsive behaviors in clinical settings.

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Abstract. Negative urgency defined as the tendency to act rashly when faced with intense negative emotions and hostile attribution bias (HAB) which refers to the tendency to interpret the intention of others as hostile when social context cues are ambiguous are two key psychological factors underlying reactive aggression. However, the specific associations between these factors in relation to reactive aggression have not been tested yet with competing models. The objective of the study was to test three putative models: (1) negative urgency moderates the association between HAB and reactive aggression; (2) HAB mediates the link between negative urgency and reactive aggression; (3) negative urgency mediates the relation between HAB and reactive aggression. One-hundred seventy-six participants were given self-report questionnaires to assess impulsivity, reactive aggression, as well as vignettes featuring a social situation measuring HAB in response to an ambiguous social provocation. The results showed that negative urgency constitutes a significant mediator in the association between HAB and reactive aggression. These results provide valuable insight into the cognitive processes underlying reactive aggression and may hold implications for diagnosis and intervention on aggressive behaviors.