In psychology, impulsivity (or impulsiveness) is a tendency to act on a whim, displaying behavior characterized by little or no forethought, reflection, or consideration of the consequences.^[1] Impulsive actions are typically "poorly conceived, prematurely expressed, unduly risky, or inappropriate to the situation that often result in undesirable consequences,"^[2] which imperil long-term goals and strategies for success.^[3] Impulsivity can be classified as a multifactorial construct.^[4] A functional variety of impulsivity has also been suggested, which involves action without much forethought in appropriate situations that can and does result in desirable consequences. "When such actions have positive outcomes, they tend not to be seen as signs of impulsivity, but as indicators of boldness, quickness, spontaneity, courageousness, or unconventionality."^[2][5] Thus, the construct of impulsivity includes at least two independent components: first, acting without an appropriate amount of deliberation,^[2] which may or may not be functional; and second, choosing short-term gains over long-term ones.^[6]

Impulsivity is both a facet of personality and a major component of various disorders, including FASD, ADHD,^[7] substance use disorders,^[8][9] bipolar disorder,^[10] antisocial personality disorder,^[11] and borderline personality disorder.^[10] Abnormal patterns of impulsivity have also been noted in instances of acquired brain injury^[12] and neurodegenerative diseases.^[13] Neurobiological findings suggest that there are specific brain regions involved in impulsive behavior,^[14][15][16] although different brain networks may contribute to different manifestations of impulsivity,^[17][18] and that genetics may play a role.^[19]

Many actions contain both impulsive and compulsive features, but impulsivity and compulsivity are functionally distinct. Impulsivity and compulsivity are interrelated in that each exhibits a tendency to act prematurely or without considered thought and often include negative outcomes.^[20][21] Compulsivity may be on a continuum with compulsivity on one end and impulsivity on the other, but research has been contradictory on this point.^[22] Compulsivity occurs in response to a perceived risk or threat, impulsivity occurs in response to a perceived immediate gain or benefit,^[20] and, whereas compulsivity involves repetitive actions, impulsivity involves unplanned reactions.

Impulsivity is a common feature of the conditions of gambling and alcohol addiction. Research has shown that individuals with either of these addictions discount delayed money at higher rates than those without, and that the presence of gambling and alcohol abuse lead to additive effects on discounting.^[23]

An impulse is a wish or urge, particularly a sudden one. It can be considered as a normal and fundamental part of human thought processes, but also one that can become problematic, as in a condition like obsessive-compulsive disorder,^{[24][unreliable medical source?]} borderline personality disorder, attention deficit hyperactivity disorder, or in fetal alcohol spectrum disorders.

The ability to control impulses, or more specifically control the desire to act on them, is an important factor in personality and socialization. Deferred gratification, also known as impulse control is an example of this, concerning impulses primarily relating to things that a person wants or desires. Delayed gratification comes when one avoids acting on initial impulses. Delayed gratification has been studied in relation to childhood obesity. Resisting the urge to act on impulses is important to teach children, because it teaches the value of delayed gratification.^[25]

Many psychological problems are characterized by a loss of control or a lack of control in specific situations. Usually, this lack of control is part of a pattern of behavior that also involves other maladaptive thoughts and actions, such as substance abuse problems or sexual disorders like the paraphilias (e.g. pedophilia and exhibitionism). When loss of control is only a component of a disorder, it usually does not have to be a part of the behavior pattern, and other symptoms must also be present for the diagnosis to be made. (Franklin^{[26][unreliable medical source?]})

For many years it was understood that impulsivity is a trait but with further analysis it can be found that there were five traits that can lead to impulsive actions: positive urgency, negative urgency, sensation seeking, lack of planning, and lack of perseverance.^{[27][28][29][30]}

Attention deficit-hyperactivity disorder (ADHD) is a multiple component disorder involving inattention, impulsivity, and hyperactivity. The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR)^[31] breaks ADHD into three subtypes according to the behavioral symptoms: Attention-Deficit/Hyperactivity Disorder Predominantly Inattentive Type, Attention-Deficit/Hyperactivity Disorder Predominantly Hyperactive-Impulsive Type, and Attention-Deficit/Hyperactivity Disorder Combined Type.

Predominantly hyperactive-impulsive type symptoms may include fidgeting and squirming in seats, talking nonstop, dashing around and touching or playing with anything in sight, having trouble sitting still during dinner/school/story time, being constantly in motion, and having difficulty doing quiet tasks or activities.

Other manifestations primarily of impulsivity include being very impatient, having difficulty waiting for things they want or waiting their turns in games, often interrupting conversations or others' activities, or blurting out inappropriate comments, showing their emotions without restraint, and act without regard for consequences.

Prevalence of the disorder worldwide is estimated to be between 4% and 10%, with reports as low as 2.2% and as high as 17.8%. Variation in rate of diagnoses may be attributed to differences between populations (i.e. culture), and differences in diagnostic methodologies.^[32] Prevalence of ADHD among females is less than half that of males, and females more commonly fall into the inattentive subtype.^[33]

Despite an upward trend in diagnoses of the inattentive subtype of ADHD, impulsivity is commonly considered to be the central feature of ADHD, and the impulsive and combined subtypes are the major contributors to the societal costs associated with ADHD.^[33][34] The estimated cost of illness for a child with ADHD is $14,576 (in 2005 dollars) annually.^[35] Prevalence of ADHD among prison populations is significantly higher than that of the normal population.^[36]

In both adults^[37] and children,^[38][39] ADHD has a high rate of comorbidity with other mental health disorders such as learning disability, conduct disorder, anxiety disorder, major depressive disorder, bipolar disorder, and substance use disorders.

The precise genetic and environmental factors contributing to ADHD are relatively unknown, but endophenotypes offer a potential middle ground between genes and symptoms.^[40] ADHD is commonly linked to "core" deficits involving "executive function," "delay aversion," or "activation/arousal" theories that attempt to explain ADHD through its symptomology.^[40] Endophenotypes, on the other hand, purport to identify potential behavioral markers that correlate with specific genetic etiology. There is some evidence to support deficits in response inhibition as one such marker. Problems inhibiting prepotent responses are linked with deficits in pre-frontal cortex (PFC) functioning, which is a common dysfunction associated with ADHD and other impulse-control disorders.^[41][42]

Evidence-based psychopharmacological and behavioral interventions exist for ADHD.^[43]

Impulsivity appears to be linked to all stages of substance abuse.^[44][45]

The acquisition phase of substance abuse involves the escalation from single use to regular use.^[44] Impulsivity may be related to the acquisition of substance abuse because of the potential role that instant gratification provided by the substance may offset the larger future benefits of abstaining from the substance, and because people with impaired inhibitory control may not be able to overcome motivating environmental cues, such as peer pressure.^[46] "Similarly, individuals that discount the value of delayed reinforcers begin to abuse alcohol, marijuana, and cigarettes early in life, while also abusing a wider array of illicit drugs compared to those who discounted delayed reinforcers less."^[47]

Escalation or dysregulation is the next and more severe phase of substance abuse. In this phase individuals "lose control" of their addiction with large levels of drug consumption and binge drug use. Animal studies suggest that individuals with higher levels of impulsivity may be more prone to the escalation stage of substance abuse.^[44]

Impulsivity is also related to the abstinence, relapse, and treatment stages of substance abuse. People who scored high on the Barratt Impulsivity Scale (BIS) were more likely to stop treatment for cocaine abuse.^[48] Additionally, they adhered to treatment for a shorter duration than people that scored low on impulsivity.^[48] Also, impulsive people had greater cravings for drugs during withdrawal periods and were more likely to relapse. This effect was shown in a study where smokers that test high on the BIS had increased craving in response to smoking cues, and gave into the cravings more quickly than less impulsive smokers.^[49] Taken as a whole the current research suggests that impulsive individuals are less likely to abstain from drugs and more likely to relapse earlier than less impulsive individuals.^[44]

While it is important to note the effect of impulsivity on substance abuse, the reciprocating effect whereby substance abuse can increase impulsivity has also been researched and documented.^[44] The promoting effect of impulsivity on substance abuse and the effect of substance abuse on increased impulsivity creates a positive feedback loop that maintains substance seeking behaviors. It also makes conclusions about the direction of causality difficult. This phenomenon has been shown to be related to several substances, but not all. For example, alcohol has been shown to increase impulsivity while amphetamines have had mixed results.^[44]

Substance use disorder treatments include prescription of medications such as acamprosate, buprenorphine, disulfiram, LAAM, methadone, and naltrexone,^[50] as well as effective psychotherapeutic treatment like behavioral couples therapy, CBT, contingency management, motivational enhancement therapy, and relapse prevention.^[50]

Impulsive overeating spans from an episode of indulgence by an otherwise healthy person to chronic binges by a person with an eating disorder.^{[citation needed]}

Consumption of a tempting food by non-clinical individuals increases when self-regulatory resources are previously depleted by another task, suggesting that it is caused by a breakdown in self control.^[51] Impulsive eating of unhealthy snack foods appears to be regulated by individual differences in impulsivity when self-control is weak and by attitudes towards the snack and towards healthy eating when self-control is strong.^[52] There is also evidence that greater food consumption occurs when people are in a sad mood, although it is possible that this is due more to emotional regulation than to a lack of self-control.^[53] In these cases, overeating will only take place if the food is palatable to the person, and if so individual differences in impulsivity can predict the amount of consumption.^[54]

Chronic overeating is a behavioral component of binge eating disorder, compulsive overeating, and bulimia nervosa. These diseases are more common for women and may involve eating thousands of calories at a time. Depending on which of these disorders is the underlying cause, an episode of overeating can have a variety of different motivations. Characteristics common among these three disorders include low self-esteem, depression, eating when not physically hungry, preoccupation with food, eating alone due to embarrassment, and feelings of regret or disgust after an episode. In these cases, overeating is not limited to palatable foods.^[55]

Impulsivity differentially affects disorders involving the overcontrol of food intake (such as anorexia nervosa) and disorders involving the lack of control of food intake (such as bulimia nervosa). Cognitive impulsivity, such as risk-taking, is a component of many eating disorders, including those that are restrictive.^[56] However, only people with disorders involving episodes of overeating have elevated levels of motoric impulsivity, such as reduced response inhibition capacity.^[56]

One theory suggests that binging provides a short-term escape from feelings of sadness, anger, or boredom, although it may contribute to these negative emotions in the long-term.^[57] Another theory suggests that binge eating involves reward seeking, as evidenced by decreased serotonin binding receptors of binge-eating women compared to matched-weight controls^[58] and predictive value of heightened reward sensitivity/drive in dysfunctional eating.^[59]

Treatments for clinical-grade overeating include cognitive behavioral therapy to teach people how to track and change their eating habits and actions, interpersonal psychotherapy to help people analyze the contribution of their friends and family in their disorder, and pharmacological therapies including antidepressants and SSRIs.^[60]

Impulse buying consists of purchasing a product or service without any previous intent to make that purchase.^[61] It has been speculated to account for as much as eighty percent of all purchases^[62] in the United States.^[relevant?]

There are several theories pertaining to impulsive buying. One theory suggests that it is exposure combining with the speed that a reward can be obtained that influences an individual to choose lesser immediate rewards over greater rewards that can be obtained later.^[63] For example, a person might choose to buy a candy bar because they are in the candy aisle even though they had decided earlier that they would not buy candy while in the store.

Another theory is one of self-regulation^[57] which suggests that the capacity to refrain from impulsive buying is a finite resource. As this capacity is depleted with repeated acts of restraint susceptibility to purchasing other items on impulse increases.^{[citation needed]}

Finally, a third theory suggests an emotional and behavioral tie between the purchaser and the product which drives both the likelihood of an impulsive purchase as well as the degree that a person will retroactively be satisfied with that purchase result.^[64][65] Some studies have shown a large number of individuals are happy with purchases made on impulse (41% in one study^[66]) which is explained as a preexisting emotional attachment which has a positive relationship both with the likelihood of initiating the purchase as well as mitigating post purchase satisfaction.^[65] As an example, when purchasing team-related college paraphernalia a large percentage of those purchases are made on impulse and are tied to the degree with which a person has positive ties to that team.^[65]

Impulsive buying is seen both as an individual trait in which each person has a preconditioned or hereditary allotment, as well as a situational construct which is mitigated by such things as emotion in the moment of the purchase and the preconditioned ties an individual has with the product.^[57][65]

Psychotherapy and pharmacological treatments have been shown to be helpful interventions for patients with impulsive-compulsive buying disorder.^[67] Psychotherapy interventions include the use of desensitization techniques,^[68] self-help books^[69] or attending a support group.^[69] Pharmacological interventions include the use of SSRIs, such as fluvoxamine,^[70][71] citalopram,^[72][73] escitalopram,^[74] and naltrexone.^[75][76]

Impulse control disorder (ICDs) are a class of DSM diagnoses that do not fall into the other diagnostic categories of the manual (e.g. substance use disorders), and that are characterized by extreme difficulty controlling impulses or urges despite negative consequences.^[31] Individuals suffering from an impulse control disorder frequently experience five stages of symptoms: compelling urge or desire, failure to resist the urge, a heightened sense of arousal, succumbing to the urge (which usually yields relief from tension), and potential remorse or feelings of guilt after the behavior is completed.^[77] Specific disorders included within this category include intermittent explosive disorder, kleptomania, pathological gambling, pyromania, trichotillomania (hair-pulling disorder), and impulse control disorders not otherwise specified (ICD NOS). ICD NOS includes other significant difficulties that seem to be related to impulsivity but do not meet the criteria for a specific DSM diagnosis.^[31]

There has been much debate over whether or not the ICDs deserve a diagnostic category of their own, or whether they are in fact phenomenologically and epidemiologically related to other major psychiatric conditions like obsessive-compulsive disorder (OCD), affective disorders, and addictive disorders.^[78] In fact, the ICD classification is likely to change with the release of the DSM-V in May 2013.^[79] In this new revision the ICD NOS will likely be reduced or removed; proposed revisions include reclassifying trichotillomania (to be renamed hair-pulling disorder) and skin-picking disorder as obsessive-compulsive and related disorders, moving intermittent explosive disorder under the diagnostic heading of disruptive, impulse control, and conduct disorders, and gambling disorder may be included in addiction and related disorders.^[79]

The role of impulsivity in the ICDs varies. Research on kleptomania and pyromania is lacking, though there is some evidence that greater kleptomania severity is tied to poor executive functioning.^[80]

Trichotillomania and skin-picking disorder seem to be disorders that primarily involve motor impulsivity,^[81][82] and will likely be classified in the DSM-V within the obsessive-compulsive and related disorders category.^[79]

Pathological gambling, in contrast, seems to involve many diverse aspects of impulsivity and abnormal reward circuitry (similar to substance use disorders) that has led to it being increasingly conceptualized as a non-substance or behavioral addiction.^[83] Evidence elucidating the role of impulsivity in pathological gambling is accumulating, with pathological gambling samples demonstrating greater response impulsivity, choice impulsivity, and reflection impulsivity than comparison control samples.^[83] Additionally, pathological gamblers tend to demonstrate greater response perseveration (compulsivity) and risky decisionmaking in laboratory gambling tasks compared to controls, though there is no strong evidence suggesting that attention and working memory are impaired in pathological gamblers.^[83] These relations between impulsivity and pathological gambling are confirmed by brain function research: pathological gamblers demonstrate less activation in the frontal cortical regions (implicated in impulsivity) compared to controls during behavioral tasks tapping response impulsivity, compulsivity, and risk/reward.^[83] Preliminary, though variable, findings also suggest that striatal activation is different between gamblers and controls, and that neurotransmitter differences (e.g. dopamine, serotonin, opioids, glutamate, norepinephrine) may exist as well.^[83]

Individuals with intermittent explosive disorder, also known as impulsive aggression, have exhibited serotonergic abnormalities and show differential activation in response to emotional stimuli and situations.^[84] Notably, intermittent explosive disorder is not associated with a higher likelihood of diagnosis with any of the other ICDs but is highly comorbid with disruptive behavior disorders in childhood.^[84] Intermittent explosive disorder is likely to be re-classified in the DSM-V under the heading of disruptive, impulse control, and conduct disorders.^[79]

These sorts of impulse control disorders are most often treated using certain types of psychopharamcological interventions (e.g. antidepressants) and behavioral treatments like cognitive behavioral therapy.^{[citation needed]}

According to the ego (or cognitive) depletion theory of impulsivity, self-control refers to the capacity for altering one's own responses, especially to bring them into line with standards such as ideals, values, morals, and social expectations, and to support the pursuit of long-term goals.^[85] Self-control enables a person to restrain or override one response, thereby making a different response possible.^[85] A major tenet of the theory is that engaging in acts of self-control draws from a limited "reservoir" of self-control that, when depleted, results in reduced capacity for further self-regulation.^[86][87] Self-control is viewed as analogous to a muscle: Just as a muscle requires strength and energy to exert force over a period of time, acts that have high self-control demands also require strength and energy to perform.^[88] Similarly, as muscles become fatigued after a period of sustained exertion and have reduced capacity to exert further force, self-control can also become depleted when demands are made of self-control resources over a period of time. Baumeister and colleagues termed the state of diminished self-control strength ego depletion (or cognitive depletion).^[87]

The strength model of self-control asserts that:

• Just as exercise can make muscles stronger, there are signs that regular exertions of self-control can improve willpower strength.^[89] These improvements typically take the form of resistance to depletion, in the sense that performance at self-control tasks deteriorates at a slower rate.^[85] Targeted efforts to control behavior in one area, such as spending money or exercise, lead to improvements in unrelated areas, such as studying or household chores. And daily exercises in self-control, such as improving posture, altering verbal behavior, and using one's nondominant hand for simple tasks, gradually produce improvements in self-control as measured by laboratory tasks.^[85] The finding that these improvements carry over into tasks vastly different from the daily exercises shows that the improvements are not due to simply increasing skill or acquiring self-efficacy from practice.^[85]
• Just as athletes begin to conserve their remaining strength when their muscles begin to tire, so do self-controllers when some of their self-regulatory resources have been expended. The severity of behavioral impairment during depletion depends in part on whether the person expects further challenges and demands.^[85] When people expect to have to exert self-control later, they will curtail current performance more severely than if no such demands are anticipated.^[90]
• Consistent with the conservation hypothesis, people can exert self-control despite ego depletion if the stakes are high enough. Offering cash incentives or other motives for good performance counteracts the effects of ego depletion.^[91] This may seem surprising but in fact it may be highly adaptive. Given the value and importance of the capacity for self-control, it would be dangerous for a person to lose that capacity completely, and so ego depletion effects may occur because people start conserving their remaining strength.^[85] When people do exert themselves on the second task, they deplete the resource even more, as reflected in severe impairments on a third task that they have not anticipated.^[90]

Empirical tests of the ego-depletion effect typically adopt dual-task paradigm.^[86][92][93] Participants assigned to an experimental ego-depletion group are required to engage in two consecutive tasks requiring self-control.^[88] Control participants are also required to engage in two consecutive tasks, but only the second task requires self-control. The strength model predicts that the performance of the experimental-group on the second self-control task will be impaired relative to that of the control group. This is because the finite self-control resources of the experimental participants will be diminished after the initial self-control task, leaving little to draw on for the second task.^[85]

The effects of ego depletion do not appear to be a product of mood or arousal. In most studies, mood and arousal has not been found to differ between participants who exerted self-control and those who did not.^[86][94] Likewise, mood and arousal was not related to final self-control performance.^[94] The same is true for more specific mood items, such as frustration, irritation, annoyance, boredom, or interest as well. Feedback about success and failure of the self-control efforts does not appear to affect performance.^[95] In short, the decline in self-control performance after exerting self-control appears to be directly related to the amount of self-control exerted and cannot be easily explained by other, well-established psychological processes.^[94]

Zdroj:https://en.wikipedia.org?pojem=Impulsiveness
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