Impulsivity: Four ways five factors are not basic to addiction
Introduction
Impulsivity, whether measured by self-report, observer-report, or behavioral performance, is a robust predictor of current and future problems with substance use (Dawe and Loxton, 2004, Jentsch and Taylor, 1999, Moeller et al., 2001, Moffitt et al., 2011, Nigg et al., 2006, Potenza, 2013, Tarter et al., 2003). In children, its association with future substance use remains even after controlling for other markers of risk, including low IQ, socioeconomic status, and parental history of substance dependence (Moffitt et al., 2011, Nigg et al., 2006, Tarter et al., 2003). Not surprisingly, the construct is of great interest to addiction scientists.
In addiction science, there is an emerging consensus that impulsive drug use involves two core processes observable at the neurophysiological, behavioral, cognitive, and trait levels. The first involves a heightened propensity, or impulse, to approach drugs and the second involves a reduced capacity to inhibit this approach behavior. The summary presented in Table 1 highlights the considerable overlap of different theoretical models in the importance placed on these two fundamental processes. Notably, these models have been derived from multiple researchers across diverse methodological investigations.
While a two-factor model is attractive in its parsimony, other researchers have proposed that a more useful way to consider impulsivity is to develop a more nuanced delineation of subtypes. This would have important implications for addiction science. In an attempt to “bring order to the myriad of measures and conceptions of impulsivity”, Whiteside and Lynam (2001, p. 684) drew upon the Five Factor Model of human personality (Costa and McCrae, 1992, Goldberg, 1993) as a framework for conceptualizing impulsivity. Employing factor analysis of self-report data, they constructed the four-factor UPPS impulsivity questionnaire consisting of: Urgency, (lack of) Premeditation, (lack of) Perseverance, and Sensation seeking. Subsequently, Cyders et al. (2007) argued that the UPPS model was incomplete, in that it did not incorporate impulsive behavior arising from positive mood states. They proposed that individual differences in this tendency were important to consider in understanding risky behavior such as alcohol abuse, and used factor analysis to derive an additional scale to measure the construct. Thus, the Urgency subscale was renamed Negative Urgency and a new scale added, Positive Urgency. We refer to this extended model as the UPPS + P model.
Notably, UPPS Sensation Seeking and (lack of) Premeditation align somewhat with the core processes previously implicated in impulsive substance use, and impulsivity theories more generally (Table 1). However, as the authors themselves note, “(lack of) perseverance, like urgency, is not well represented in other measures of impulsivity” (Whiteside & Lynam, 2001, p. 685C). The same could be said of Positive Urgency (Cyders et al., 2007). In debating the importance of these newly constructed impulsivity traits, the field finds itself in a situation strikingly similar to that which took place in the personality literature, in particular, the debate between Costa and McCrae (1992) and Eysenck (1992). In a paper entitled “Four ways five factors are basic”, Costa and McCrae outlined four lines of evidence to support the five-factor model of personality. This was followed by Eysenck's reply entitled, “Four ways five factors are not basic”, in which he argued against each of the proposed lines of evidence. Eysenck concluded with a strong call for a science of personality based on theoretical predictions firmly rooted in biological processes.
Many of the issues raised during the personality debate are relevant for addiction researchers studying impulsivity. Specifically, 1) the use of factor analysis as an atheoretical ‘truth-grinding’ machine; 2) whether additional facets of a construct add explanatory power over fewer; 3) the delineation of specific neurocognitive pathways from each facet to addictive behavior, and; 4) the relative merit of ‘top-down’ versus ‘bottom-up’ approaches to the understanding of impulsivity and the integration of experimental evidence. Each of these issues will be discussed, in turn, with reference to current research into impulsivity and substance abuse. While the proceeding discussion focuses on the UPPS + P model, the issues raised apply equally to any top-down theory of impulsivity driven largely by self-report questionnaire data. It is hoped that this critical review of the literature will stimulate further refinements to the understanding of impulsivity and highlight the importance of theoretical integration across fields.
Section snippets
Factor analysis is not a ‘truth-grinding’ machine
The UPPS and UPPS + P are models of impulsivity borne of factor analysis. Using this statistical technique, Whiteside and Lynam (2001) set out to distil the numerous conceptualizations of impulsivity into core facets common across measures. The Five Factor Model of personality, itself a product of factor analysis, was used as the framework within which to ‘anchor’ these facets within personality more broadly. It should be noted, however, that only three of the Big Five were included as anchors,
Ockham's razor: do additional traits increase explanatory power?
Prior to considering the evidence for additional facets of impulsivity it is worth considering whether a two-factor model provides additional explanatory power over and above a single factor. The relationship between measures tapping into one factor, Reward Sensitivity, and substance use is well-established (e.g., Dissabandara et al., 2014, Franken and Muris, 2006, Gullo and Dawe, 2008, Kabbani and Kambouropoulos, 2013, Kambouropoulos and Staiger, 2004, Knyazev et al., 2004, Loxton and Dawe,
Neurocognitive pathways linking impulsivity facets to addictive behavior
Neurobiological models of addiction vulnerability highlight the importance of two interrelated neural processes: heightened incentive salience arising from the limbic “impulsive” system and impaired response inhibition arising from the prefrontal “executive” system (see Table 1). All drugs of abuse (directly or indirectly) activate the mesolimbic dopamine system, with the nucleus accumbens playing a critical role in their acute reinforcing effects (Koob & Volkow, 2010). Repeated
The relative merit of ‘top-down’ versus ‘bottom-up’ approaches to understanding impulsivity
“In the long run, any account of behaviour which does not agree with the knowledge of the nervous and endocrine system which has been gained through the direct study of physiology must be wrong” — Jeffrey A. Gray (from The psychology of fear and stress [1987; 2nd ed.], p. 241).
It is clear from the above discussion that the lack of theoretical integration with other lines of research is a major obstacle for UPPS + P going forward. While research to-date has failed to support unique contributions
Concluding remarks
In summary, impulsivity is a core vulnerability to addictive behavior. However, five factors are not basic to addiction. There is broad agreement across different levels of analysis that traits related to Reward Sensitivity and Disinhibition play an important and unique role in addictive behavior. These processes are reflected, to varying degrees, in the UPPS + P traits of Sensation Seeking and (Lack of) Premeditation. However, it is likely that UPPS + P Sensation Seeking does not fully capture
Role of Funding Source
Dr Gullo is supported by a National Health and Medical Research Council (NHMRC) of Australia Early Career Fellowship (APP1036365).
Contributors
All authors contributed to the development of the review, including the first draft and subsequent revisions.
Conflict of interest
No conflict declared.
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