Another look at impulsivity: A meta-analytic review comparing specific dispositions to rash action in their relationship to bulimic symptoms

doi:10.1016/j.cpr.2008.09.001

Clinical Psychology Review

Volume 28, Issue 8, December 2008, Pages 1413-1425

https://doi.org/10.1016/j.cpr.2008.09.001 Get rights and content

Abstract

Recent advances in personality theory indicate that there are distinct constructs that dispose individuals to rash action and risky behavior, as opposed to one broad trait of impulsivity. Two are emotion based, two represent deficits in conscientiousness, and one is sensation seeking. Previous studies of impulsivity and its relationship to bulimia nervosa have yielded mixed findings. The authors applied this advance in personality theory to the study of bulimia nervosa (BN) to test the hypothesis that the emotion-based disposition of negative urgency (the tendency to act rashly when distressed) relates most strongly to BN symptoms. A meta-analysis of 50 articles indicated the following. Negative urgency had by far the largest effect size (weighted r = .38), followed by sensation seeking (weighted r = .16); lack of planning (weighted r = .16) and lack of persistence (weighted r = .08). Methodological moderators of the effect of distinct traits on BN symptoms were the use of scales that precisely measured one construct as opposed to general impulsivity scales that measured several constructs, clinical vs. non-clinical samples, and whether or not the personality scale was translated from its original language or not. Negative urgency appears especially important for BN; more broadly, researchers should consider the role of emotion-based dispositions to rash acts in their risk theories.

Section snippets

Theoretical advances in the study of personality and impulsivity

Recent studies indicate that the term impulsivity encompasses a wide range of traits that are only moderately related, rather than a single uni-dimensional personality characteristic (Smith et al., 2007, Whiteside and Lynam, 2001, Cyders and Smith, 2007). First, emotion-based dispositions to rash action have been identified. Negative urgency is the tendency to act rashly when experiencing negative mood. More recently, positive urgency, the tendency to act rashly when experiencing extremely

Trait theory, impulsivity, and distinct dispositions to rash action

Historical descriptions of impulsivity from both temperament and trait perspectives do suggest the presence of multiple dispositions to rash action. While several different personality researchers have presented models of impulsivity, they all have common elements. A construct representing lack of forethought is represented in Buss and Plomin's (1975) model of temperament, Costa and McCrae's (1992) representation of the Five Factor Model of personality, Zuckerman's “alternative five factor

Personality, eating disorders, and the role of negative urgency

The search for personality contributors to eating disorders has suggested the potential importance of both negative emotionality and impulsivity (Lilenfeld et al., 2006, Stice, 2002). Negative emotionality or neuroticism seems consistently to be associated with binge purge symptoms (Cassin and von Ranson, 2005, Lilenfeld et al., 2006), whereas the evidence for impulsivity has been less clear. On the one hand, clinicians describe binge eating behavior, and subsequent purging behavior, as

Selection of studies

A literature search was conducted using four different methods. The search covered articles published up to October 2007. First, PsychInfo and Medline databases were examined using several combinations of key words. Key words included all possible combinations of dependent variables of interest: “bulimia, binge eating, binge, eating, and purging;” and personality variables of interest: “impulsivity, sensation seeking, deliberation, urgency, persistence, perseverance, and novelty seeking.”

Study sample

A total of 222 studies were retrieved based on the literature search described above. Of these, 50 articles met inclusion criteria. Table 3 displays the studies included in the meta-analysis, grouped by trait construct, with a brief description of the design of the study, sample size, and effect size. (Note that several studies contributed more than one effect size as they assessed multiple constructs). Among the non-included articles, 47 were non meta-analytic review articles or theoretical

Discussion

At the broadest level, the results of this meta-analysis offer two conclusions to clinical researchers. The first is that when one measures the personality basis for rash action, one should define precisely the nature of the trait of interest. Not all traits have the same relationships to at least some forms of dysfunction. The second is to appreciate the importance of emotion-based dispositions to rash action. In the case of symptoms of BN, affect appears to play a central role in the rash

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^☆: Portions of this research were supported by NIAAA award 5 F31 AA016265 to Melissa Cyders, NIAAA award 5 F31 AA014469-02 to Sarah Fischer, both under the supervision of Gregory Smith and by NIAAA award R01 AA016166 to Gregory Smith.

^⁎: Indicates study that was used in meta-analysis.

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Another look at impulsivity: A meta-analytic review comparing specific dispositions to rash action in their relationship to bulimic symptoms☆

Abstract

Section snippets

Theoretical advances in the study of personality and impulsivity

Trait theory, impulsivity, and distinct dispositions to rash action

Personality, eating disorders, and the role of negative urgency

Selection of studies

Study sample

Discussion

Behavior Therapy

Behaviour Research and Therapy

Eating Behaviors

Journal of the American Academy of Child and Adolescent Psychiatry

Clinical Psychology Review

Journal of Anxiety Disorders

Personality and Individual Differences

Eating Behaviors

Personality and Individual Differences

Personality and Individual Differences

Behaviour Research and Therapy

Journal of Psychosomatic Research

Comprehensive Psychiatry

Personality and Individual Differences

Personality and Individual Differences

Journal of Adolescence

Personality and Individual Differences

Clinical Psychology Review

Personality and Individual Differences

Personality and Individual Differences

Comprehensive Psychiatry

Drug and Alcohol Dependence

Psychological Bulletin

Personality and Individual Differences

Addictive Behaviors

Psychiatry Research

Factors related to severity of vomiting behaviors in bulimia nervosa

Psychiatry Research

The classification of child psychopathology: A review and analysis of empirical efforts

Psychological Bulletin

Personality, temperament, and character dimensions and the DSM-IV personality disorders in substance abusers

Journal of Abnormal Psychology

Impulsivity: Integrating cognitive, behavioral, biological and environmental data

Relationship of temperament and perceptions of nonshared environment in bulimia nervosa

International Journal of Eating Disorders

‘Chasing’ in gambling behavior: Personality and cognitive determinants

Personality and Individual Differences

Personality and family environment predictors of self-reported eating attitudes and behaviors

Journal of Personality Assessment

Laxative misuse and behavioral disinhibition in bulimia nervosa

International Journal of Eating Disorders

Impulsivity in disordered eating, affective disorder, and substance use disorder

British Journal of Psychiatry

A temperament theory of personality development

Temperament as a unifying basis for personality and psychopathology

Journal of Abnormal Psychology

The Tridimensional Personality Questionnaire: US normative data

Psychological Reports

A psychobiological model of temperament and character

Archives of General Psychiatry

Statistical power analysis for the behavioral sciences

Revised NEO personality inventory manual

Impulsivity as an underlying factor in the relationship between disordered eating and sexual behavior

International Journal of Eating Disorders

Integration of impulsivity and positive mood to predict risky behavior: Development and validation of a measure of positive urgency

Psychological Assessment

Prospective study of the integration of mood and impulsivity to predict increases in maladaptive action during the first year of college

Neurobiology of the structure of personality: DA, facilitation of incentive motivation, and extraversion

Behavioral and Brain Sciences

A study of temperament and personality in anorexia and bulimia nervosa

Journal of Personality Disorders

Functional and dysfunctional impulsivity: Personality and cognitive correlates

Journal of Personality and Social Psychology

Impulsivity: A discussion of clinical and experimental findings

Journal of Psychopharmacology

Manual of the Eysenck personality inventory