The factor structure of the Barratt Impulsiveness Scale (BIS-11) and correlates of impulsivity among outpatients with schizophrenia and other psychotic disorders in Singapore

Abstract

Background Impulsivity has been linked to risky behaviours amongst patients with schizophrenia or other psychotic disorders. However, there is a dearth of studies examining impulsivity amongst this population in Singapore. Moreover, to date, scales to measure impulsivity have not been validated in this population. The present study seeks to examine the underlying factor structure of the Barratt Impulsiveness Scale (BIS-11) and explore sociodemographic and clinical correlates of impulsivity within this group. Methods Confirmatory factor analyses (CFA) were conducted to test factor structures of the BIS-11 proposed in extant literature. However, due to poor fit statistics, the sample (n = 397) was split into two groups, with Exploratory Factor Analyses (EFA) conducted in the first subgroup (n = 200). The final model of the EFA was then tested within the second subgroup (n = 197) with CFA. Multivariable linear regressions were conducted to examine sociodemographic and clinical correlates of each underlying factor. Results CFA indicated a three-factor structure amongst 16-items of the BIS-11 with acceptable fit: i) Non-planning impulsivity (5-items; α = 0.94), ii) Motor impulsiveness (6-items α = 0.84), and iii) Lack of self-control (5-items, α = 0.85). Lower education was associated with higher non-planning impulsivity. While age, ethnicity, marital status, and general psychiatric symptom severity were significant correlates of motor impulsiveness, problematic alcohol use and general psychiatric symptom severity were related to a greater lack of self-control. Conclusion Factor structures of the BIS-11 suggested by extant literature were not applicable, and we propose an alternative factor structure for BIS-11. Significant correlates of impulsivity are highlighted, and avenues for future research are suggested.

Correlation Between Aggressive Behavior and Impulsive and Aggressive Personality Traits in Stable Patients with Schizophrenia

“…The inconsistencies in the above conclusions may be related to regional and cultural differences, selection of included cases, and sample size. 11,41 This study showed that the total PANSS, positive factors, general pathological factors, and disease severity scores were all higher in the aggressive group than in the non-aggressive group, which is similar to the result of research by van Dongen JD et al 42 Meanwhile, this study found that the group with aggressive behavior had better insight, which was contrary to the results of Witt et al, 15 who found that violence is closely related to a lack of insight. However, our results were supported by Schandrin et al study, 41 which speculated that insight may trigger the expression of an underlying hostile tendency, possibly via depression and self-stigmatization.…”

“…The inconsistencies in the above conclusions may be related to regional and cultural differences, selection of included cases, and sample size. 11 , 41 …”

“…Multiple causes often coexist in a single aggressive event: 8 for example, imaging studies have found that patients with aggressive behavior have abnormalities in brain structure and function. 9 , 10 In terms of social demography, reported risk factors include youth, 11 male sex, 12 low education level, 13 singleness, unemployment, 14 etc. Comorbidities of substance abuse have been suggested to be strong predictors of aggressive behavior in patients with schizophrenia.…”

“… 2 , 21 , 29 , 30 In addition, researchers in the United States have pointed out racial differences in impulsive behavior. 31 As differences in cultural background, living environment, and even religious belief may affect aggressive behavior, 11 we need to conduct corresponding research on the personality traits of patients with schizophrenia with aggressive behaviors in China. To address this need, and the shortcomings of the previous research conducted in China, the current study used a large sample size and multi-stratified in-depth exploration was conducted to explore the influence of impulsivity and aggressive personality traits on aggressive behavior in stable patients with schizophrenia.…”

Impulsivity and Attention in Obsessive Compulsive and Tic Disorders: Mismatch in Self-Report and Behavioural Data

“…Impulsivity represents an important building block in our understanding of behaviour beyond defined psychiatric diagnoses. Despite the information already acquired, there is often still no consensus regarding its exact dimensional classification [ 78 , 79 , 80 , 81 ]. Further studies with larger cohorts are therefore of great importance for a detailed understanding of this behavioural phenomenon.…”