Do facets of self-reported impulsivity predict decision-making under ambiguity and risk? Evidence from a community sample

Abstract

We investigated the links among decision-making assessed by the Iowa Gambling Task (IGT) and the Game of Dice Task (GDT), and the four facets of impulsivity (urgency, lack of premeditation, lack of perseverance, and sensation seeking, UPPS) proposed by Whiteside and Lynam (2001) in a sample of 107 healthy volunteers. Hierarchical regressions controlling for age and gender indicated that sensation seeking and urgency were linked to disadvantageous decisions on the GDT while no association was found between IGT performance and the UPPS. Sensation seeking and urgency facets of impulsivity are related in healthy individuals, to decision-making processes where potential consequences of different options and their subsequent probabilities rely on explicit information. In healthy controls, there is little overlap between decision-making influenced by both implicit and explicit information and impulsivity as measured by the UPPS. These findings add evidence to the notion that self-reported trait impulsivity is associated with the decision making process. Decisions made under risk seemed to be differentially associated with specific facets of impulsivity.

Introduction

Impulsivity appears to be a fundamental part of disruptive behavior disorders, substance abuse, personality disorders, aggression, bipolar disorder, and other potentially destructive behavioral problems (for a review see Evenden, 1999, Enticott and Ogloff, 2006). This concept is included in the diagnostic criteria of many disorders (Evenden, 1999). For decades, there has been a lack of consensus on how to define and measure the concept of impulsivity. In early 2000, Whiteside and Lynam (2001) proposed a new model for understanding the personality pathways to impulsive behavior (Whiteside and Lynam, 2001). They identified four distinct personality facets associated with impulsive-like behavior, which were labeled urgency, (lack of) premeditation, (lack of) perseverance, and sensation seeking, and validated the UPPS Impulsive Behavior Scale that assesses these four facets of impulsivity. The first dimension of the scale, urgency, refers to difficulty resisting strong impulses driven by negative affect. The second dimension, premeditation, is characterized by an inability to consider the potential consequences of one's behavior. The third dimension, perseverance, refers to the lack of ability to stay on task while experiencing boredom. Finally, sensation seeking refers to an individual's need for excitement and stimulation.

Poor decision-making is a core symptom of certain psychiatric conditions such as drug dependence, bipolar disorder (for a comprehensive review see Dunn et al., 2006), pathological gambling (for review and original data see Kertzman et al., 2011), suicidal behaviors (Jollant et al., 2005) and some forms of eating disorder (e.g. Brand et al., 2007a, Liao et al., 2009, Brogan et al., 2010). This was illustrated by the observation of an abnormal response pattern in experimental decision-making tasks such as the Iowa Gambling Task (IGT) (Bechara et al., 2000) and the Game of Dice Task (GDT) (Brand et al., 2005a). The IGT is considered to simulate decision-making in real-life situations in which premises, outcomes, rewards, or punishments are uncertain. In this task, subjects have to make choices by picking cards from four decks that are either long-term advantageous or disadvantageous. Participants do not know at the beginning of the gamble that decks are advantageous and disadvantageous. By contrast, in the GDT, the potential consequences of different options and their subsequent probabilities rely on explicit information (Brand et al., 2006). This task consists of 18 trials in which one single virtual die is shaken and participants have to ‘guess’ which number (1–6) will be thrown. The participants can choose among different alternatives (1 single number or a combination of 2, 3 or 4 numbers) that are explicitly related to a specific amount of gain/loss (1000–100 Euro) and have obvious winning probabilities (1:6 to 4:6) in each trial.

Impaired decision-making on the IGT has been interpreted as the consequence of insensitivity to future consequences, positive or negative (Bechara et al., 2000). In a major article, Bechara et al. (1997) reported that healthy participants decide advantageously before having a conscious knowledge of the advantageous choices. Furthermore, they showed larger anticipatory skin conductance responses prior to selecting a card from the disadvantageous decks compared to the advantageous decks. The authors concluded that somatic markers may assist the decision-making process in the IGT more than conscious knowledge. Successful GDT performances appear highly linked to performance in tasks measuring executive functions (Brand et al., 2005b, Brand et al., 2006, Brand et al., 2007b, Brand et al., 2008) and to activation in the cerebral network involved in executive functions (i.e. dorsolateral prefrontal cortex, posterior parietal lobe, anterior cingulate, and right lingual gyrus) (Labudda et al., 2008).

As mentioned earlier, it is well known that the personality trait of impulsivity is a major component in several psychiatric disorders, including the aforementioned disorders (Evenden, 1999, Enticott and Ogloff, 2006). However, the relations between individual differences and decision-making processes and, more specifically, the relations between impulsivity and this kind of process are poorly understood. In early work on the IGT, Bechara et al. (2000) found that around 20–30% of normal adults performed disadvantageously on the IGT (Bechara et al., 2000). Those participants with impaired behavioral performance were characterized post hoc as “high risk takers”. Understanding the relationship between decision-making processes and impulsivity has implications for the interpretation of “impaired” performance in individuals who complete the IGT and the GDT as part of a clinical evaluation. Altered decision-making may simply reflect individual differences in preference for risk. Thus, selection of risky options can be perfectly rational depending on the individual's preference structure.

To the best of our knowledge, there are currently only three studies that have investigated the relationships between the UPPS and the IGT performances in healthy controls. These studies have obtained mixed results: Perales et al. (2009) found no relationship between impulsivity and decision-making, whereas Zermatten et al. (2005) reported that lack of premeditation was specifically linked to disadvantageous decisions. More recently, higher urgency was found to be associated with poor IGT performances (Billieux et al., 2010). Additionally, to our knowledge, nothing has been reported about relations between decision-making under risk assessed by the GDT and the multifaceted impulsivity model.

The aim of the present study was to attempt to clarify relations between decision-making under ambiguity and under risk performances as assessed on control participants by two well-validated tasks (IGT and GDT) and the multifaceted impulsivity model as measured by the UPPS. Through the use of a multifaceted impulsivity measure, we hope to bring clarity to the relations between facets of impulsivity and decision-making. Because there are limited impulsivity data on the IGT and the GDT, it is important to emphasize that our study is largely an exploratory investigation. Nevertheless, based upon previous studies and the nature of the IGT and the GDT, several relations are hypothesized. Concerning the IGT, the key feature of this task is that participants have to forego short-term benefit for long-term profit. It is consequently hypothesized that the UPPS dimension of urgency will relate to disadvantageous choices. Poor decision-making on the IGT has been interpreted as “myopia” for the future or as deficient anticipation of future outcomes in decision-making processes (Bechara and Van Der Linden, 2005). We therefore expect that the UPPS scale assessing lack of premeditation will relate to the inability to predict long-term punishments and rewards based on previous experience (i.e. preference for “risky” choices). The urgency facet of impulsivity has been associated with the occurrence of a wide range of disruptive behavior disorders (for a review, see Cyders and Smith, 2008) in which executive deficits are frequently documented (e.g. Goudriaan et al., 2004, Gillberg et al., 2010, Hester et al., 2010, Schuermann et al., 2011). In particular, this facet has been shown to reflect a relative inability to deliberately suppress dominant, automatic or prepotent responses (Gay et al., 2008). Given the converging evidence of executive deficits and poor performance on the GDT, one may hypothesize that an individual with a high level of urgency may prefer risky alternatives.