Compulsive Aspects of Impulse-Control Disorders

Grant, Jon E.; Potenza, Marc N.

doi:10.1016/j.psc.2006.02.002

Cited by 155 publications

(83 citation statements)

References 62 publications

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“…Impulsive disorders are often described as having compulsive features. For example, kleptomania and pathological gambling are considered impulsive disorders, yet those afflicted often describe obsessing about stealing or gambling and feeling compelled to do so [41].…”

Section: Discussionmentioning

confidence: 99%

Impulsivity, Compulsivity, and Habit: The Role of Orbitofrontal Cortex Revisited

Torregrossa

Quinn

Taylor

2008

Biological Psychiatry

134

100

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Humans suffering damage to the orbitofrontal cortex (OFC) are often described as impulsive. The most famous example is Phineas Gage, a railway worker, who in 1848 suffered extreme frontal lobe damage when a long iron rod was projected through his skull after an accidental explosion. Gage survived, but was reported to have an extreme change in personality, including increased inappropriate behavior (impulsiveness) [1][2]. People with OFC lesions are more impulsive compared to both normal controls and people with non-OFC frontal cortex damage, as measured by self-report and by cognitive/behavioral tasks [3]. But, how is impulsivity defined and how can it be measured? Impulsivity involves behaviors that are inappropriate for the context, premature, poorly planned and often resulting in adverse consequences. Impulsive behaviors have been described as having three dimensions: 1) an inability to use available information to reflect on the consequences of actions; 2) an inability to forego an immediate small reward in favor of a delayed larger reward; 3) a deficit in suppressing prepotent motor responses [4]. Taken together, these three dimensions of impulsivity reflect an inability to evaluate and subsequently respond flexibly in search of a specific goal or outcome under changing environmental conditions. In this commentary, we reflect on the similarities between impulsive, compulsive and habitual behavior and hypothesize a common neurobiological circuit that depends critically on the function of the OFC.The 'toggle' between flexible, goal-directed actions and reflexive, stimulusdriven habitsIn combination with its well-described involvement in inhibitory control [5;6] the prefrontal cortex (PFC) -including the OFC --is critical for decision-making and response-selection. The PFC is impaired in disorders of impulsivity and compulsivity such as drug addiction, obsessive compulsive disorder, attention-deficit disorder and Tourette syndrome [5;7-12].Distinct regions of the PFC work in concert with the striatum, forming a distributed network responsible for processing of reward information, reward-related learning, goal-directed actions and the formation of habits [13][14][15][16][17][18][19][20]. For example, during the acquisition of actions such as lever-pressing, performance is controlled by an expectation of the future consequences Address reprint requests to Jane R. Taylor, PhD Division of Molecular Psychiatry, S307 CMHC, New Haven, CT 06508; E-mail: jane.taylor@yale.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public AccessAuthor Manuscript Biol Psychiatry. Aut...

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Section: Discussionmentioning

confidence: 99%

Impulsivity, Compulsivity, and Habit: The Role of Orbitofrontal Cortex Revisited

Torregrossa

Quinn

Taylor

2008

Biological Psychiatry

134

100

View full text Add to dashboard Cite

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“…The disorders frequently co-occur and show similarities with respect to symptom profiles, gender differences, natural histories, and familial propensities (Grant and Potenza, 2006). Pathological gambling and SA show high levels of impulsivity on reward-discounting tasks, which correlate with poor measures of functioning (Bechara, 2003) and poor treatment outcome (Krishnan-Sarin et al, 2007) for individuals with SAs and thus may have prognostic value for pathological gambling and other ICDs.…”

Section: Impulsivity and 'Behavioral' Addictionsmentioning

confidence: 99%

Probing Compulsive and Impulsive Behaviors, from Animal Models to Endophenotypes: A Narrative Review

Fineberg

Potenza

Chamberlain

et al. 2009

Neuropsychopharmacol

584

468

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Failures in cortical control of fronto-striatal neural circuits may underpin impulsive and compulsive acts. In this narrative review, we explore these behaviors from the perspective of neural processes and consider how these behaviors and neural processes contribute to mental disorders such as obsessive-compulsive disorder (OCD), obsessive-compulsive personality disorder, and impulse-control disorders such as trichotillomania and pathological gambling. We present findings from a broad range of data, comprising translational and human endophenotypes research and clinical treatment trials, focussing on the parallel, functionally segregated, cortico-striatal neural projections, from orbitofrontal cortex (OFC) to medial striatum (caudate nucleus), proposed to drive compulsive activity, and from the anterior cingulate/ventromedial prefrontal cortex to the ventral striatum (nucleus accumbens shell), proposed to drive impulsive activity, and the interaction between them. We suggest that impulsivity and compulsivity each seem to be multidimensional. Impulsive or compulsive behaviors are mediated by overlapping as well as distinct neural substrates. Trichotillomania may stand apart as a disorder of motor-impulse control, whereas pathological gambling involves abnormal ventral reward circuitry that identifies it more closely with substance addiction. OCD shows motor impulsivity and compulsivity, probably mediated through disruption of OFC-caudate circuitry, as well as other frontal, cingulate, and parietal connections. Serotonin and dopamine interact across these circuits to modulate aspects of both impulsive and compulsive responding and as yet unidentified brain-based systems may also have important functions. Targeted application of neurocognitive tasks, receptor-specific neurochemical probes, and brain systems neuroimaging techniques have potential for future research in this field.

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“…In this regard, some researchers have labeled hypersexuality as a manifestation of a compulsive driven sexual desire [65]. However, compulsivity also involves the repetition of the same often purposeless and unpleasant behaviors, often enacted to prevent perceived unwanted consequences, which can lead to impaired functioning [66][67][68][69]. This latter aspect of compulsivity likely differentiates hypersexual behavior given the pleasure derived from sexual behavior is incongruent with behaviors generally associated with a compulsion (e.g., washing hands).…”

Section: Impulsivity Vs Compulsivitymentioning

confidence: 99%

Sexual Impulsivity in Hypersexual Men

Reid

Berlin

Kingston

2015

Curr Behav Neurosci Rep

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Hypersexual behavior is an emerging construct that is receiving increased attention from both clinicians and researchers. Several theoretical perspectives exist about hypersexuality and its associated characteristics. Although the role of impulsivity and how it might be linked to hypersexuality are still being investigated, this article attempts to highlight some of the important concepts related to impulsivity and how they differ from compulsivity. Findings from the field of neuroscience and psychology are integrated to give readers a broader perspective about existing perspectives about the etiology and mechanisms that might link impulsivity with hypersexual behavior. A theoretical model of sexuality impulsivity among hypersexual individuals is discussed, and we conclude by offering some future possibilities for researchers attempting to understand this construct.

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Compulsive Aspects of Impulse-Control Disorders

Cited by 155 publications

References 62 publications

Impulsivity, Compulsivity, and Habit: The Role of Orbitofrontal Cortex Revisited

Impulsivity, Compulsivity, and Habit: The Role of Orbitofrontal Cortex Revisited

Probing Compulsive and Impulsive Behaviors, from Animal Models to Endophenotypes: A Narrative Review

Sexual Impulsivity in Hypersexual Men

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