Recommendations for applying a multi-dimensional model of impulsive personality to diagnosis and treatment

Um, Miji; Hershberger, Alexandra R.; Whitt, Zachary T.; Cyders, Melissa A.

doi:10.1186/s40479-018-0084-x

Cited by 27 publications

(19 citation statements)

References 127 publications

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“…This accumulating evidence supports the notion that negative urgency is a transdiagnostic endophenotype for problematic levels of behaviors associated with risk (28). This includes not only addictive behaviors, but also disorders highly comorbid with these conditions, such as depression, anxiety, and bipolar disorders (5, 28, 29). Negative urgency is represented in broad diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition ( DSM-5 ) (29).…”

Section: Negative Urgency As a Transdiagnostic Risk And Treatment Factormentioning

confidence: 99%

Integrating Preclinical and Clinical Models of Negative Urgency

2019

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Overwhelming evidence suggests that negative urgency is robustly associated with rash, ill-advised behavior, and this trait may hamper attempts to treat patients with substance use disorder. Research applying negative urgency to clinical treatment settings has been limited, in part, due to the absence of an objective, behavioral, and translational model of negative urgency. We suggest that development of such a model will allow for determination of prime neurological and physiological treatment targets, the testing of treatment effectiveness in the preclinical and the clinical laboratory, and, ultimately, improvement in negative-urgency-related treatment response and effectiveness. In the current paper, we review the literature on measurement of negative urgency and discuss limitations of current attempts to assess this trait in human models. Then, we review the limited research on animal models of negative urgency and make suggestions for some promising models that could lead to a translational measurement model. Finally, we discuss the importance of applying objective, behavioral, and translational models of negative urgency, especially those that are easily administered in both animals and humans, to treatment development and testing and make suggestions on necessary future work in this field. Given that negative urgency is a transdiagnostic risk factor that impedes treatment success, the impact of this work could be large in reducing client suffering and societal costs.

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Section: Negative Urgency As a Transdiagnostic Risk And Treatment Factormentioning

confidence: 99%

Integrating Preclinical and Clinical Models of Negative Urgency

2019

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“…We view negative urgency as a transdiagnostic endophenotype and distal factor not only for addictive behaviors, such as substance use disorders, pathological gambling, and disordered eating, but also various clinical problems that are comorbid with addictive behaviors such as depression, anxiety, personality disorders, schizophrenia, and bipolar disorders [8,103,104,105,106,107,108]. As such, there is a great need for negative urgency to become a critical target in the treatment and intervention process instead of focusing on single or couple disorders [109]. Given its clinical importance and a high relapse rate after drug addiction treatment [110], understanding the neural underpinnings of negative urgency provides a novel avenue for effective treatment development, and we propose that future research be done to design and test such approaches.…”

Section: Applications To Treatment and Intervention And Suggestionmentioning

confidence: 99%

Shared Neural Correlates Underlying Addictive Disorders and Negative Urgency

Whitt

Revilla

et al. 2019

Brain Sciences

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Negative urgency is a personality trait reflecting the tendency to act rashly in response to extreme negative emotions and is considered a transdiagnostic endophenotype for problematic levels of addictive behaviors. Recent research has begun to identify the neural correlates of negative urgency, many of which appear to overlap with neural circuitry underlying addictive disorders associated with negative urgency. The goal of this qualitative review is to summarize the extant literature concerning the neural correlates of negative urgency, to compare these correlates with those implicated with addictive disorders, and to propose new ways to begin to leverage such findings in treatment and intervention approaches. We also address current limitations in the field and make recommendations for areas for future growth in this research domain. Patterns of structure and function in the ventral striatum, frontal regions, such as the prefrontal cortex (PFC) and orbitofrontal cortex (OFC), and amygdala are common across addictive disorders and are related to both real-world risky behaviors and self-report measures of negative urgency. We propose that the time has come to move past considering this trait and these disorders as completely separate entities, and instead for the field to consider how general patterns of convergence across these disorders can lead to a more transdiagnostic approach to treatment and intervention. We suggest future work utilize these convergent patterns in the development of animal models of negative urgency, in the identification and testing of prime pharmacological and physiological interventions, and as objective biomarkers to be used when testing behavioral, pharmacological, and physiological intervention effectiveness. Little empirical work has been done to date in these areas and advances in these nascent fields would advance understanding and applications of the neuroscience of negative urgency.

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“…Se trata de un fenómeno complejo que requiere de un abordaje terapéutico también complejo. Para poder diseñarlo, necesitamos un modelo Fernando Gamba, Marilina Graziola, Juan Marino, Marcos Urgorri, Mariano Castellaro psicopatológico acorde con dicha característica (Bowins, 2010;Um, Hershberger, Whitt y Cyders, 2018).…”

Section: Introductionunclassified

Los trastornos de la personalidad desde una perspectiva dimensional

Gamba

Graziola²,

Marino³

et al. 2020

Persona

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In the field of clinical psychology, there is a growing consensus about the deficiencies of the categorical diagnosis system for personality disorders (PD), since it is insufficient to cover the dysfunctional experiences of patients. These deficiencies cause an incomplete system, since it excludes essential and idiosyncratic information necessary to better understand the patients. Moreover, this situation negatively affects the adequate conceptualization of the problems and the design of the interventions. If too many difficulties arise when implementing a diagnostic model in psychotherapy, it is possible to think that the model should be modified instead of trying to adjust psychotherapy to the model. The conceptualization of PD from the so-called "dimensional perspective" makes it possible to address the special features of each subject and, thus, improve the quality of the interventions. This work aims to explain how such dimensional perspective, which currently has a strong empirical support, can improve the clinical understanding of these disorders and their therapeutic intervention.

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Recommendations for applying a multi-dimensional model of impulsive personality to diagnosis and treatment

Cited by 27 publications

References 127 publications

Integrating Preclinical and Clinical Models of Negative Urgency

Integrating Preclinical and Clinical Models of Negative Urgency

Shared Neural Correlates Underlying Addictive Disorders and Negative Urgency

Los trastornos de la personalidad desde una perspectiva dimensional

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