Abstract
Background and aims
Due to its important role in both healthy groups and those with physical, mental and behavioral disorders, impulsivity is a widely researched construct. Among various self-report questionnaires of impulsivity, the Barratt Impulsiveness Scale is arguably the most frequently used measure. Despite its international use, inconsistencies in the suggested factor structure of its latest version, the BIS-11, have been observed repeatedly in different samples. The goal of the present study was therefore to test the factor structure of the BIS-11 in several samples.
Methods
Exploratory and confirmatory factor analyses were conducted on two representative samples of Hungarian adults (N = 2,457; N = 2,040) and a college sample (N = 765).
Results
Analyses did not confirm the original model of the measure in any of the samples. Based on explorative factor analyses, an alternative three-factor model (cognitive impulsivity; behavioral impulsivity; and impatience/restlessness) of the Barratt Impulsiveness Scale is suggested. The pattern of the associations between the three factors and aggression, exercise, smoking, alcohol use, and psychological distress supports the construct validity of this new model.
Discussion
The new measurement model of impulsivity was confirmed in two independent samples. However, it requires further cross-cultural validation to clarify the content of self-reported impulsivity in both clinical and nonclinical samples.
Introduction
The construct of impulsivity contributes importantly to many classic personality theories (Buss & Plomin, 1975; Cloninger, 1987; Costa & McRae, 1985; Eysenck & Eysenck, 1977; Zuckerman, 1979), and efforts to assess appropriately this construct have persisted over recent decades (e.g., Cyders & Smith, 2008; Hamilton et al., 2015a, 2015b; Reise, Moore, Sabb, Brown, & London, 2013; Smith et al., 2007; Steinberg, Sharp, Stanford, & Tharp, 2013; Swann, Bjork, Moeller, & Dougherty, 2002; Whiteside & Lynam, 2001). The clinical relevance of impulsivity is frequently highlighted because it impacts many mental and behavioral disorders including impulse-control disorders (Grant & Potenza, 2006; Stein, Hollander, & Liebowitz, 1993), attention deficit and hyperactivity disorder (Barkley, 1997; Winstanley, Eagle, & Robbins, 2006), substance-use disorders (Conway, Kane, Ball, Poling, & Rounsaville, 2003; Verdejo-García, Lawrence, & Clark, 2008), behavioral addictions such as gambling (e.g., Blaszczynski, Steel, & McConaghy, 1997; Canale, Vieno, Griffiths, Rubaltelli, & Santinello, 2015; Potenza, Kosten, & Rounsaville, 2001), paraphilias (e.g., Kafka, 1996, 2003), antisocial personality disorder (e.g., Swann, Lijffijt, Lane, Steinberg, & Moeller, 2009), and borderline personality disorder (e.g., Dougherty, Bjork, Huckabee, Moeller, & Swann, 1999; Links, Heslegrave, & van Reekum, 1999). Impulsivity also significantly influences therapeutic co-operation and prognosis of treatment (e.g., Alvarez-Moya et al., 2011; Ryan, 1997). Consequently, reliable and valid measurements of impulsivity are important.
The present paper focuses on an impulsivity measure that is based on the theoretical framework proposed by Barratt (1965) and later by Barratt and Stanford (1995), including biological, cognitive, social, and behavioral aspects of the construct. However, these approaches only represent specific aspects (i.e., traits related to cognition, attention, self-control, or motor impulsivity) of the much broader umbrella construct of impulsivity. As Depue and Collins (1999) pointed out, impulsivity can be interpreted as a cluster of numerous traits such as sensation seeking, risk-taking, adventuresomeness, boredom susceptibility, or unreliability, many of which are not represented in Barratt and Stanford's approach. Similarly, emotionally laden impulsivity – which is also missing from the aforementioned conceptual framework – is considered to be a truly relevant aspect of the construct in predicting later psychopathology (Berg, Latzman, Bliwise, & Lilienfeld, 2015). The multi-dimensional UPPS/UPPS-P model of impulsivity (Whiteside & Lynam, 2001), including the traits of negative urgency, lack of premeditation, lack of perseverance, sensation seeking, and positive urgency, represents an integrated model and also offers a clear link between emotionally-driven impulsivity and various behavioral measures, including the assessment of aggression (e.g., Bousardt, Noorthoorn, Hoogendoorn, Nijman, & Hummelen, 2018), snack food consumption (Coumans et al., 2018), alcohol use (e.g., Shin, Lee, Jeon, & Wills, 2015) and dependence (Kim et al., 2018), as well as other forms of addictive disorder (Rømer Thomsen et al., 2018). Impulsivity may be assessed by both tests of performance (e.g., Bender, 1938; Dougherty, 1999; Golden, 1978; Heaton, Chelune, Talley, Kay, & Curtiss, 1993; Kagan, Rosman, Day, Albert, & Phillips, 1964) and self-report scales (Table 1 summarizes these measures).
Widely used self-report impulsivity measures
| Name of self-report measure | Reference | Original number of items | Original number of scales/factors (latent structure) | Conceptual framework |
| Emotionality Activity, Sociability and Impulsivity inventory (EASI-III) | Buss and Plomin (1975) | 20 | 10 scales (General emotionality, Fear, Anger, Tempo, Vigor, Sociability, Lack of inhibitory control, Decision time, Lack of persistence, and Sensation Seeking) | Impulsivity as a basic temperament and tendency to respond quickly instead of response inhibition |
| I-7: Impulsiveness and Venturesomeness Questionnaire Eysenck et al. (1985) | Eysenck and Eysenck (1977) | 54 | 3 subscales (Impulsiveness, Venturesomeness, and Empathy) | Impulsivity as one of the facet of the Psychoticism-Extraversion-Neuroticism model |
| Dickman Impulsiveness Scale | Dickman (1990) | 23 | 2 subscales (Dysfunctional impulsivity, and Functional impulsivity) | Impulsivity as a multifaceted trait that does not necessarily lead to dysfunctional outcomes but may predict optimal human functioning |
| Zuckerman-Kuhlman Personality Questionnaire | Zuckerman et al. (1993) | 99 | 5 factors (Impulsive Sensation Seeking, Sociability, Neuroticism-Anxiety, Aggression-Hostility, and Activity) | Impulsivity as one of the dimensions of the Five Factor Models of personality |
| Behavioral Inhibition and Activation Scales (BIS/BAS) | Carver and White (1994) | 24 | 2 scales (BIS and BAS), 4 subscales (BIS: Sensitivity for punishment, BAS: Reward Responsiveness, Drive, and Fun seeking) | Impulsivity as the product of the competing neural circuits of “Stop” (regulatory/executive/behavioral inhibition) and ”Go” (reward-driven behavioral activation) |
| Barratt Impulsivity Scale (BIS-11) | Patton et al. (1995) | 30 | 3 second-order factors (Attentional, Motor and Non-planning impulsivity), | Impulsivity as a multifaceted predisposition |
| 6 first-order factors (Attention, Cognitive instability, Motor, Perseverance, Self-control, and Cognitive complexity) | ||||
| The Urgency, Premeditation, Perseverance, and Sensation Seeking (UPPS) Impulsive Behavior Scale | Whiteside and Lynam (2001) | 45 | 4 subscales (Premeditation, Urgency, Sensation Seeking, and Perseverance) | Impulsivity as one of the dimensions of the Five Factor Models of personality |
| Frontal Systems Behavior Scale (FrSBe) | Grace and Malloy (2001) | 46 | 3 factors (Executive Dysfunction with Apathy, Executive | Impulsivity as a consequence of brain damage and orbitofrontal dysfunction |
| Dysfunction with Disinhibition, and Disinhibition with Apathy) | ||||
| Multidimensional Personality Questionnaire (MPQ) | Patrick et al. (2002) | 276 | 11 primary trait factors (Wellbeing, Potency, Achievement, Social Closeness, Stress Reaction, Alienation, Aggression, Control, Harm Avoidance, Traditionalism, and Absorption) | Impulsivity as an underlying trait that induces trait-consistent behaviors |
| Brief Self Control Scale (BSCS) | Tangney et al. (2004) | 36 (long version) 13 (brief version) | Unidimension of self-control | Impulsivity as the result of lacking self-regulation |
Regarding the latter measures, a frequently used self-report scale is the Barratt Impulsivity Scale (BIS) (Patton, Stanford, & Barratt, 1995). The BIS, in its initial form, measured several dimensions of impulse control, including behavioral (e.g., psychomotor efficacy), cognitive (e.g., the rapidity of cognitive responses) and physiological (e.g., heart rhythm) aspects (Barratt, 1965). The first version of the BIS comprised 80 items. However, more recently the number of items has been reduced to 30 in order to increase construct validity and to improve other psychometric characteristics (Patton et al., 1995). The revised (11th) version of the scale (BIS-11) comprises six first-order factors and three second-order factors. The first-order factors are Attention and Cognitive Instability (together they comprise the second-order factor Attentional Impulsivity), Motor and Perseverance (together Motor Impulsivity), and Self-control and Cognitive Complexity (together Non-planning Impulsivity).
However, attempts to validate the BIS-11 have usually resulted in factor structures different from the original one (Table 2 summarizes sample characteristics, applied statistics, and factorial solutions described within these studies). Although the factor structure described by Patton and colleagues (1995) was essentially confirmed in Japanese (Someya et al., 2001), Spanish (Oquendo et al., 2001) and Chinese (Yang, Yao, & Zhu, 2007) samples, only non-planning impulsivity was reproduced in an Italian study (Fossati, Di Ceglie, Acquarini, & Barratt, 2001). Furthermore, the majority of validating studies did not confirm the original model.
Characteristics of former validation studies of BIS-11
| Reference | Language version | Study sample | Type of analyses | Factorial structure | Additional comments | |
| Patton et al. (1995) | English | College undergraduates (n = 412) Psychiatric inpatients (n = 248) Male prison inmates (n = 73) | Exploratory principal components analysis (PCA) | First-order factors | Second-order factors | |
| Attention | Attentional impulsivity | |||||
| Cognitive Instability | ||||||
| Motor | Motor impulsivity | |||||
| Perseverance | ||||||
| Self-control | Non-planning impulsivity | |||||
| Cognitive Complexity | ||||||
| Someya et al. (2001) | Japanese | Female college tudents (n = 34) Hospital workers (n = 416) | Confirmatory factor analysis (CFA) | Attention | Attentional impulsivity | |
| Cognitive Instability | ||||||
| Motor | Motor impulsivity | |||||
| Perseverance | ||||||
| Self-control | Non-planning impulsivity | |||||
| Cognitive Complexity | ||||||
| Oquendo et al. (2001) | Spanish | Psychiatric outpatients (n = 29) | Measuring scale equivalences | Attention | Attentional impulsivity | |
| Cognitive Instability | ||||||
| Motor | Motor impulsivity | |||||
| Perseverance | ||||||
| Self-control | Non-planning impulsivity | |||||
| Cognitive Complexity | ||||||
| Fossati et al. (2001) | Italian | College undergraduates (n = 763) | Exploratory principal components analysis (PCA) | Attention | Attentional and motor impulsiveness | |
| Motor impulsiveness | ||||||
| Lack of delayed gratification | Perseverance and lack of delayed gratification | |||||
| Perseverance | ||||||
| Self-control | Non-planning impulsivity | |||||
| Cognitive complexity | ||||||
| Miller et al. (2004) | English | Adults from the general population (n = 245) | Principal components analysis (PCA) | Attention | Cognitive impulsiveness | The high inter-relationship of the three subscales indicates a more general impulsivity factor |
| Cognitive Instability | ||||||
| Motor | Motor impulsiveness | |||||
| Perseverance | ||||||
| Self-control | Non-planning impulsiveness | |||||
| Cognitive Complexity | ||||||
| Surís et al. (2005) | English | Treatment seeking U.S. veteran soldiers (n = 474) | Explaratory factor analysis (EFA) | Attention | Cognitive impulsiveness | Due to the high inter-relationship of the three subscales, BIS subscale scores do not provide any additional information over the total score |
| Cognitive Instability | ||||||
| Motor | Motor impulsiveness | |||||
| Perseverance | ||||||
| Self-control | Non-planning impulsiveness | |||||
| Cognitive Complexity | ||||||
| Yang et al. (2007) | Chinese | Undergraduate university students (n = 209) | Confirmatory factor analysis (CFA) | Attention | Attentional impulsivity | |
| Cognitive Instability | ||||||
| Motor | Motor impulsivity | |||||
| Perseverance | ||||||
| Self-control | Non-planning impulsivity | |||||
| Cognitive Complexity | ||||||
| Paaver et al. (2007) | Estonian | Young adults from a longitudinal study (n = 683) | Inter-item correlation | 27 out of 31 items formed a single impulsivity scale | The BIS total score was used instead of distinct subscales | |
| Von Diemen et al. (2007) | Brazilian Portuguese | Male adolescents and young adults (n = 464) | Explaratory factor analysis (EFA) | Items form lack of attention | Factor 1 | Items 4, 17, 18, 23, 24, 26, and 27 were excluded from the factorial solution |
| Items from lack of planning | ||||||
| Motor | Factor 2 | |||||
| Items from the lack of attention and planning subscales | ||||||
| Items from the lack of planning subscale | Factor 3 | |||||
| Güleç et al. (2008) | Turkish | College undergraduates (n = 237) Psychiatric patients (n = 83) | Exploratory principal components analysis (PCA) | Attention | Attentional impulsivity | Not all the original items loaded in the same original factor group and except for the total score and the first second-order factor, all subscales of BIS-11 showed inadequate levels of internal consistencies. |
| Cognitive Instability | ||||||
| Motor | Motor impulsivity | |||||
| Perseverance | ||||||
| Self-control | Non-planning impulsivity | |||||
| Cognitive Complexity | ||||||
| Ireland and Archer (2008) | English | Subsamples of adult men prisoners (n = 383 and 250) Subsamples of adult women prisoners (n = 250 and 220) | Explaratory factor analysis (EFA) Confirmatory factor analysis (CFA) | Items from the original Attentional, Motor and Non-planning impulsivity scales | Distractibility | Items 3 and 22 failed to load in any factor, furthermore, the three factor solution did not fit the data for women, only after the Distractibility factor was removed |
| Items from the original Attentional, Motor and Non-planning impulsivity scales | Behavioral impulsivity | |||||
| Items from the original Attentional, Motor and Non-planning impulsivity scales | Cognitive planning skills | |||||
| Preuss et al. (2008) | German | Controls from the general population (n = 810) Psychiatric inpatients (n = 211) | Confirmatory factor analysis (CFA) | Adequate factor reliability was found only in the case of Self-control and Motor impulsivity | No alternative factorial solution was suggested | |
| Haden and Shiva (2009) | English | Mentally ill forensic inpatients (n = 327) | Confirmatory factor analysis (CFA) | 12 items | Motor impulsivity | Items 3, 5, 16, 23, 24, 27 were exluded and a two-factor solution was retained |
| 12 items | Non-planning impulsivity | |||||
| Steinberg et al. (2013) | English | Undergraduate university students (n = 1,178) | Item bifactor analysis (IBA) | A unidimensional impulsivity construct (including the original items: 1, 2, 5, 8, 9, 12, 14, 19) | More than half of the items did not have a substantial relation to the general underlying impulsivity construct, therefore a unidimensional model and an 8-item brief measurement tool (BIS-Brief) was suggested | |
| Ellouze et al. (2013) | Arabic | Adults from the general population (n = 134) | Exploratory principal components analysis (PCA) | Items 10, 12, 13, 15 and 18 | Cognitive impulsivity | |
| Items 14, 17 and 28 | Motor impulsivity | |||||
| Items 8 and 20 | Non-planning impulsivity | |||||
| Reise et al. (2013) | English | Community sample (n = 691) | Explaratory factor analysis (EFA) Confirmatory factor analysis (CFA) | Items from the original Attentional and Non-planning impulsivity scales | Cognitive impulsivity | Cognitive and behavioral impulsivity might also be interpreted as „method” factors representing constraint (Cognitive) and impulsivity (Behavioral) |
| Items from the original Motor and Non-planning impulsivity scales | Behavioral impulsivity | |||||
| Reid et al. (2014) | English | Three subgroups of addicted patients (methamphetamine users; pathological gamblers and hypersexual respondents) (n = 353) | Exploratory principal components analysis (PCA) Confirmatory factor analysis (CFA) | Items from the original Motor, Attentional and Non-planning impulsivity scales | Motor impulsiveness | Authors found the best fit indices for a three-factor solution but only 12 items were retained from the original BIS |
| Items from the original Motor and Non-planning impulsivity scales | Immediacy impulsiveness | |||||
| Items from the original Attentional and Non-planning impulsivity scales | Non-planning impulsiveness | |||||
| Malloy-Diniz et al. (2015) | Brazilian Portuguese | Adults from the general population (n = 3,053) | Reliability analysis for three and two-factor solutions, based on Cronbach's alpha | n.d. | Inhibition control | Authors found the best reliability for the two-factor solution recommended by Vasconcelos and colleagues (2012) |
| n.d. | Non-planning impulsivity | |||||
| Lindstrøm et al. (2017) | Norwegian | Healthy controls from the general population (n = 47) Parkinson's disease patients (n = 43) Chronic headache patients (n = 20) | Explaratory factor analysis (EFA) Confirmatory factor analysis (CFA) | Items from the original Attentional and Non-planning impulsivity scales | Cognitive impulsivity | The factorial solution was similar to the one proposed by Reise et al. (2013), however, items 3 and 4 were excluded in this analysis |
| Items from the original Motor and Non-planning impulsivity scales | Behavioral impulsivity | |||||
Note: n.d. = not described in the specific study.
Miller, Joseph and Tudway (2004) assessed the component structure of four frequently used self-report measures of impulsivity – including the BIS-11 – in the general population in Great Britain. Their results showed that the three sub-factors of the BIS-11 can be better defined as a general impulsivity factor. Miller and colleagues (2004) also delineated a three-component structure of impulsivity based on different impulsivity measures: non-planning dysfunctional, functional venturesomeness, and drive/reward responsiveness. Surís and colleagues (2005) assessed the factor structure of the BIS-11 using exploratory factor analysis (EFA) in a sample of 474 U.S. veteran soldiers, and although the three-factor solution was reproduced, the correlation between these factors was high enough to draw a conclusion that the subscale scores of BIS do not provide any additional information over the total score. Paaver and colleagues (2007) adapted the Estonian version of the scale on 683 participants, and found that 27 items of the BIS-11 formed a single scale. Consequently, they used the BIS-11 total score in further analyses. Von Diemen, Szobot, Kessler and Pechansky (2007) were unable to identify the three factors of the original scale. However, the authors suggested that the Portuguese (Brazilian) version of the BIS-11 may be used for male adolescents with some limitations (464 male adolescents partially formed their sample). Güleç and colleagues (2008) essentially replicated the original factor structure using exploratory principal-component analysis. However, the subscale item loadings in the Turkish version were different from the English versions. Furthermore, except for the total score of the scale and the first second-order factor, all subscales of BIS-11 showed inadequate levels of internal consistencies.
Different second-order factors (labeled as Cognitive Planning Skills, Behavioral Impulsivity and Distractibility) were identified in a prison sample in Great Britain (Ireland and Archer, 2008). Preuss and colleagues (2008) adapted and studied the German version of the BIS-11 in healthy individuals and patients with alcohol dependence, suicide attempts, and borderline personality disorder by using confirmatory factor analysis (CFA). The authors were unable to reproduce the original model. However, they did not suggest a new model in their study. Another study, conducted in the United States examined a sample of 327 mentally ill forensic inpatients (Haden & Shiva, 2009) and identified two factors (labeled as Motor Impulsivity and Non-planning Impulsivity), including 24 items retained from principal component analysis. Steinberg and colleagues (2013), based on their analysis on BIS-11 psychometric properties, suggested a novel unidimensional solution and a revised instrument named the Barratt Impulsiveness Scale-Brief (BIS-Brief). A preferable two-factor solution (Inhibition Control and Non-planning) was found in a Brazilian population (Malloy-Diniz et al., 2015; Vasconcelos, Malloy-Diniz, & Corrêa, 2012). Ellouze, Ghaffari, Zouari, Zouari, and M'rad (2013) assessed 134 individuals from the general population to examine the factor structure of the Arabic version of BIS-11 and reported three factors, with different item loadings from the original English version. In the United States, examination of the factor structure of the BIS-11 in individuals with gambling disorder, hypersexuality and methamphetamine dependence identified a 12-item three-factor solution including motor, non-planning and immediacy impulsiveness (Reid, Cyders, Moghaddam, & Fong, 2014). More recently, Lindstrøm, Wyller, Halvorsen, Hartberg, and Lundqvist (2017) assessed the psychometric properties of the Norwegian version of the BIS-11 in a sample of healthy individuals and patients with Parkinson's disease or headaches and reported a two-factor solution with moderate fit. This model confirmed the cognitive and behavioral factors that were originally suggested by Reise et al. (2013).
Considering these findings, it may be concluded that psychometric analyses of the BIS-11 have resulted in diverse models, indicating one-factor, two-factor, and three-factor solutions. Previous studies indicate that impulsivity assessed using the BIS might fall into the facets of cognitive, behavioral, and/or non-planning impulsiveness. However, different factor solutions have led to various interpretations regarding the underlying latent factors of the impulsivity construct. It should be noted that most of the aforementioned studies utilized relatively small sample sizes derived from special populations and non-probability/non-representative samples. Furthermore, approximately half of the studies applied only PCA or EFA without CFA, and most of these studies did not cross-validate their measurement models with independent samples. Additionally, the vast majority of the studies treated items as continuous indicators rather than as ordinal scales. BIS uses four-point Likert type response format, and it is not clear how treating this format as continuous and neglecting the floor or ceiling effects in responses may make it difficult to make a conclusion concerning the measurement model. Only one previous study reported the response distribution of BIS items reflecting that at least 13 items showed severe floor effect and two items showed ceiling effects (Martínez-Loredo, Fernández-Hermida, Fernández-Artamendi, Carballo, & García-Rodríguez, 2015). In contrast, another study simply stated the low frequency of extreme responses (Reise et al., 2013). Among studies applying a CFA approach, serious deviation from multivariate normal distribution can decrease the degree of fit when maximum likelihood estimation is applied (Finney & DiStefano, 2006). Furthermore, such studies use a response option as a linear scale instead of an ordinal scale which might impact on fit indices in measurement models.
Consequently, the aim of the present study was to analyze the factor structure of the BIS-11 in Hungary in a general population nationwide representative samples and a relatively large college sample. Given that impulsivity is best described as a multidimensional construct, including traits related to urgency, sensation seeking, impatience, or boredom susceptibility (Depue & Collins, 1999; Whiteside & Lynam, 2001), we hypothesized that when performing a CFA testing the originally proposed measurement model, we could confirm or refute the original measurement model. If the original measurement model was not supported, we intended to develop a measurement model which are consistently replicated in several samples with EFA and CFA approaches. The present study also tested the construct validity of the BIS by assessing participants' potential psychiatric symptoms, level of aggression, and various behavioral patterns (including alcohol use, smoking and physical exercise). Associations have already been demonstrated between (i) motor impulsivity, non-planning impulsivity, and increased aggression (Krakowski & Czobor, 2018), (ii) cognitive (attentional) impulsivity, depression, and alcohol dependence (Jakubczyk et al., 2012), (iii) each facet of impulsivity (attentional, motor and non-planning) and current cigarette smoking (Heffner, Fleck, DelBello, Adler, & Strakowski, 2012), and (iv) impulsivity and lower physical activity (Bénard et al., 2017).
Methods
Samples and procedure
Community Sample 1 (CS1): The BIS was assessed within the framework of the National Survey on Addiction Problems in Hungary 2007 (NSAPH2007) (Paksi, Rózsa, Kun, Arnold, & Demetrovics, 2009). This survey, in addition to the assessment of addictive behaviors, aimed to assess some personality/trait-like characteristics. The target population of the survey was the total population of Hungary between the ages of 18 and 64 years. The sampling frame comprised the whole resident population with a valid address, according to the register of the Central Office for Administrative and Electronic Public Services on January 1, 2006 (6,662,587 individuals). Data collection was executed on a gross sample of 3,183 people, stratified according to geographical location, degree of urbanization and age (overall 186 strata) representative of the sampling frame. Participants were surveyed using a ‘mixed-method’ approach via personal visits. Questions regarding background variables and introductory questions referring to some specific phenomena were asked in the course of face-to-face interviews, while symptom scales and the Brief Symptom Inventory (BSI) were applied using self-administered paper-and-pencil questionnaires. These questionnaires were returned to the interviewer in a closed envelope to ensure confidentiality. The net sample size was 2,710 (response rate: 85.1%). However, only 2,457 people completed the BIS questionnaire. The ratio of samples belonging to each stratum was adjusted to the characteristics of the sampling frame by means of a weighted matrix for each stratum category.
College Sample: This convenience sample of university and college students was collected in the context of a behavioral genetic study. The advertisements were posted in universities and colleges. Inclusion criteria was the willingness to provide genetic sampling. Only one exclusion criterion was applied (i.e., participants with known any psychiatric disorder were excluded). All participants provided written informed consent. The number of participants with valid BIS-11 data was 765 including 46.4% males and 53.6% females. Mean age was 20.96 years (SD = 2.4, skewness: 1.198, kurtosis: 1.492).
Community Sample 2 (CS2): The BIS-11 was assessed within the framework of the National Survey on Addiction Problems in Hungary 2015 (NSAPH2015) (Paksi, Demetrovics, Magi, & Felvinczi, 2017). The target population of the survey was the total population of Hungary between the ages of 18 and 64 years. The sampling frame consisted of the whole resident population with a valid address, according to the register of the Central Office for Administrative and Electronic Public Services on January 1, 2014 (6,583,433 individuals). The NSAPH2015 research was conducted on a nationally representative sample of the Hungarian adult population aged 16–64 years (gross sample 2,477, net sample 2,274 individuals) with the age group of 18–34 years being overrepresented. The size of the weighted sample of the 18–64 year-old adult population was 1,490 individuals. Statistical analysis of the weight-distribution suggests that weighting did not create any artificial distortion in the database leaving the representativeness of the sample unaffected. The extent of the theoretical margin of error in the weighted sample is ±2.5%, at a reliability level of 95% which is in line with the original data collection plans. Participants were surveyed similarly as in previous NSAPH2007 research. The sample that provided responses on the BIS (n = 2040) were used in the current CFA analysis.
Measures
Barratt Impulsiveness Scale – Eleventh Revision (BIS-11): The impulsivity was assessed using the Hungarian version of the most recent Barratt Impulsivity Scale (BIS-11) originally published by Patton et al. (1995). The questionnaire was designed to assess self-reported impulsivity of both healthy individuals and psychiatric populations. The instrument includes 30 items, scored on a four-point scale: (1) rarely/never, (2) occasionally, (3) often, (4) almost always/always. Conventionally, the three main impulsivity factors are: Attentional impulsiveness (poor attention and cognitive instability), Motor impulsiveness (motor activity and poor perseverance), and Non-planning impulsiveness (poor self-control and cognitive complexity). The total score is the sum of all the items. The English version of the questionnaire was translated using the ‘forward–backward’ procedure recommended by Beaton, Bombardier, Guillemin and Ferraz (2000). The item was translated into Hungarian and an independent translator translated the Hungarian items back to English. The original and translated versions of items were compared, and discrepancies were resolved. Following this procedure, the Hungarian items were pilot tested prior to the present study and some minor changes were carried out in order to enhance translation clarity and applicability. Although various factorial solutions were found across different studies and samples (as previously already described in the Introduction), the BIS-11 is generally characterized by acceptable or good validity and reliability indices with a Cronbach's alpha score usually higher than 0.7 for the first-order and second-order factors, and ranging between 0.62 (Von Diemen et al., 2007) and 0.80 (Yang et al., 2007) for the total BIS score.
Brief Symptom Inventory (BSI): The BSI is a 53-item self-report symptom inventory designed to assess briefly psychological symptom patterns of psychiatric and medical patients, and it reflects good psychometric properties in a Hungarian nonclinical sample (Urbán et al., 2014), and with internal consistency coefficients usually reported between 0.7 and 0.9 for its subscales and Global Severity Index in both clinical and nonclinical samples (e.g. Adawi et al., 2019; Derogatis & Spencer, 1982; Roser, Hall, & Moser, 2016). Each item of the questionnaire is rated on a five-point scale of distress from 0 (not at all) to 4 (very much). The BSI comprises nine primary symptom dimensions: somatization (which reflects distress arising from bodily perceptions), obsessive-compulsive (which reflects obsessive-compulsive symptoms), interpersonal sensitivity (which reflects feelings of personal inadequacy and inferiority in comparison with others), depression (which reflects depressive symptoms, as well as lack of motivation), anxiety (which reflects anxiety symptoms and tension), hostility (which reflects symptoms of negative affect, aggression and irritability), phobic anxiety (which reflects symptoms of persistent fears as responses to specific conditions), paranoid ideation (which reflects symptoms of projective thinking, hostility, suspiciousness, fear of loss of autonomy), and psychoticism (which reflects a broad range of symptoms from mild interpersonal alienation to dramatic evidence of psychosis) (Derogatis, 1983; Derogatis & Savitz, 2000). This measure was administered in the CS1 only. The internal consistency of the 90 items of the Global Severity Index was excellent in the present sample (0.98). Omega coefficients of the subscales ranged between 0.87 and 0.95 in the present sample (for further psychometric details, see Urbán et al., 2014).
Buss-Perry Aggression Questionnaire: This 29-item scale was developed to assess physical aggression, verbal aggression, anger, and hostility (Buss & Perry, 1992). Each item is answered on a five-point Likert-type response option, indicating how uncharacteristic or characteristic each statement is to the participant. This measure was administered in the college sample only. The questionnaire is characterized by acceptable or good reliability indices, with Cronbach's alpha scores usually exceeding 0.7 across various cultures and samples (e.g., Demırtaş Madran, 2013; Gerevich, Bácskai, & Czobor, 2007; Valdivia-Peralta, Fonseca-Pedrero, González-Bravo, & Lemos-Giráldez, 2014). In the present study, internal consistency (Cronbach's alpha) for Verbal Aggression, Physical Aggression, Anger and Hostility were 0.64, 0.84, 0.83 and 0.79, respectively.
Behavioral indicators: The present study applied current smoking, regular exercise, the frequency of drinking alcohol, problematic drinking and binge drinking as behavioral indicators to support construct validity of the impulsivity scale. Current smoking was defined as regular or occasional smoking versus non-smoking currently. Regular exercise was defined as doing any exercise at least weakly. Alcohol use was measured with frequency of the alcohol consumption during the past 30 days. An indicator of monthly or more frequent binge drinking which was defined as consuming more than 6 units of alcohol was also assessed. These indicators were administered in CS1 only.
Statistical analysis
A CFA was performed testing the originally proposed measurement model. Given that the first CFA did not provide adequate fit indices, the analytical procedure examined increasingly restrictive solutions of latent structure using EFA and CFA. Both EFAs and CFAs were performed with MPLUS 8.0 (Muthén & Muthén, 1998–2017). We treated the items as ordinal indicators and used the weighted least squares mean and variance adjusted estimation method (WLSMV; Brown, 2006; Finney & DiStefano, 2006) in both EFAs and CFAs. We used the full information maximum likelihood estimator to deal with missing data (Muthén & Muthén, 1998–2017). In the EFAs, goodness of fit is characterized by the root-mean-square error of approximation (RMSEA), its 90% confidence interval (90% CI), and Cfit with a P-value of 0.05 for test of close fit. In the CFAs, goodness of fit was evaluated using RMSEA and its 90% confidence interval (90% CI), P-value for test of close fit to 0.05, standardized root-mean-square residual (SRMR), and comparative fit index (CFI) and Tucker-Lewis Fit Index (TLI). As recommended by Brown (2006) and Kline (2005), multiple indices were selected in order to provide different information for evaluating model fit.
To conduct the analyses in the present study, we randomly selected three non-overlapping groups from the first community sample (CS1). Sample 1 (n = 802) was used to perform an initial EFA on the original items. Sample 2 (n = 827) was used to conduct a separate EFA to cross-validate the factor structure found in the first analysis. Samples 1 and 2 informed the specification of an appropriate CFA solution in Sample 3 (n = 828). Finally, the present study tested the measurement model among two independent samples comprising university and college students (Sample 4, n = 765) and another representative community sample (CS2, N = 2,040).
In order to support the construct validity of the new factor structure of BIS, we needed to demonstrate that the factors had different patterns of association with concurrent criterion variables. We applied three sets of variables. One group of criterion variables comprised psychiatric symptomatology. We expected that impulsivity would be positively associated with general psychological distress but that factors of impulsivity would show different pattern of associations with specific symptom factors (Hirschtritt, Potenza, & Mayes, 2012; Chamberlain, Stochl, Redden, & Grant, 2018). The other group of criterion variables were behavioral ones. We choose this group because previous extensive research has investigated the associations between impulsivity and substance use including smoking (Kale, Stautz, & Cooper, 2018) and alcohol use (Dick et al., 2010). We also added an indicator of regular exercise which we hypothesized would be negatively associated with impulsivity because individuals engaging in regular exercise rely on their self-control (Englert, 2016; Finne, Englert, & Jekauc, 2019). The final group of criterion variables were related with aggressive behaviors. Impulsivity and aggressiveness are closely related constructs (García-Forero, Gallardo-Pujol, Maydeu-Olivares, & Andrés-Pueyo, 2009). However, we expected that impulsivity factors would relate differently to different type of aggressive behaviors.
The data and scripts are available for a reasonable request.
Ethics
The study protocol was approved by the Local Ethical Committee (TUKEB) and Institutional Review Board of the Faculty of Education and Psychology, ELTE Eötvös Loránd University (2015/76) and the study was conducted with respect to guidelines of the Declaration of Helsinki. All subjects were informed about the study and all provided informed consent.
Results
Descriptive statistics
The community sample represented the adult population of Hungary (18–64 years). The distributions and mean ages were calculated with the sample weights in the two community samples. In the first community sample (CS1), the distributions of gender were almost equal (49% males and 51% females) and the mean age was 40.3 years (SD = 13.4). In the student sample, the distribution of gender was 46.4% males and 53.6% females, and the mean age was 20.96 years (SD = 2.4). In CS2, the distribution of gender was 46% males and 54% females, and the mean age was 41.6 years (SD = 13.2).
Confirmatory Factor Analysis (CFA) of the original measurement model of Barratt Impulsivity Scale (BIS-11)
A CFA was performed with the originally proposed measurement model in the community sample (CS1, N = 2,457) and in the student sample (N = 687). The fit indices indicated inadequate fit to the data both in the community sample (χ2 = 14,671, df = 402, P < 0.0001; CFI = 0.577; TLI = 0.543; RMSEA = 0.120 [0.119–0.122], Cfit < 0.001; SRMR = 0.121) and in the university sample (χ2 = 3,063, df = 402, P < 0.0001; CFI = 0.701; TLI = 0.677; RMSEA = 0.093 [0.090–0.096], Cfit < 0.001; SRMR = 0.093).
The one-factor measurement model was also tested because the total score of the BIS-11 has been used frequently in recent research. One total score hypothetically reflects only one factor. The fit indices also indicated inadequate level of fit (χ2 = 15,464, df = 405, P < 0.0001; CFI = 0.554; TLI = 0.521; RMSEA = 0.123 [0.121–0.125], Cfit < 0.001; SRMR = 0.126) in the community sample and also (χ2 = 3,477, df = 405 P < 0.0001; CFI = 0.701; TLI = 0.677; RMSEA = 0.100 [0.097–0.103], Cfit < 0.001; SRMR = 0.096) in the college sample. Instead of performing extensive search for the sources of misfit in modification indices and regression residuals, the analysis moved toward a more exploratory analysis as described in the Statistical Analysis section.
Developing a new model: Exploratory factor analyses (EFAs)
An EFA was performed with a robust weighted least squares (WLS) approach (estimator = WLSMV) which is applicable to ordinal level of response options and promax rotation with the 30 items on Sample 1 from CS1 (N = 802). Acceptability of the factor solution was based on goodness of fit index (RMSEA < 0.08, Cfit > 0.05, 90% CI < 0.08), the scree plot, the interpretability of the solution, and salient factor loadings (>0.30). Unfortunately, parallel analysis was not available with WLSMV estimator. One-to four-factor solutions were examined. RMSEA values were 0.119 for the one-factor solution; 0.067 for the two-factor solution; and 0.057 for the three-factor solution. Therefore, the three-factor solution was retained (χ2 = 1,256, df = 348, P < 0.0001). The first four eigenvalues for the sample correlation matrix were 6.57, 4.38, 1.75, and 1.49. Factor loadings are presented in Table 3.
Exploratory factor analysis on Barratt Impulsiveness Scale in two independent samples.
| No. | Factor 1 Cognitive impulsivity | Factor 2 Behavioral impulsivity | Factor 3 Impatience/restlessness | Communalities | |||||
| Sample 1 | Sample 2 | Sample 1 | Sample 2 | Sample 1 | Sample 2 | Sample 1 | Sample 2 | ||
| 9 | I concentrate easily | 0.79 | 0.78 | 0.08 | 0.06 | −0.20 | −0.09 | 0.61 | 0.61 |
| 12 | I am a careful thinker | 0.75 | 0.77 | −0.07 | −0.04 | −0.15 | −0.14 | 0.60 | 0.65 |
| 8 | I am self-controlled | 0.67 | 0.66 | −0.03 | −0.16 | −0.13 | −0.02 | 0.47 | 0.50 |
| 13 | I plan for job security | 0.66 | 0.57 | −0.02 | 0.05 | −0.13 | −0.05 | 0.45 | 0.32 |
| 20 | I am a steady thinker | 0.65 | 0.69 | −0.11 | −0.05 | 0.10 | 0.01 | 0.46 | 0.48 |
| 1 | I plan tasks carefully | 0.62 | 0.68 | −0.17 | −0.02 | −0.05 | −0.13 | 0.47 | 0.50 |
| 7 | I plan trips well ahead of time | 0.57 | 0.62 | −0.07 | −0.06 | 0.13 | 0.06 | 0.35 | 0.39 |
| 15 | I like to think about complex problems | 0.55 | 0.55 | 0.11 | 0.19 | 0.14 | 0.12 | 0.33 | 0.33 |
| 30 | I am future oriented | 0.50 | 0.52 | 0.04 | −0.01 | 0.13 | 0.18 | 0.27 | 0.29 |
| 10 | I save regularly | 0.47 | 0.45 | −0.07 | −0.18 | 0.17 | 0.16 | 0.26 | 0.25 |
| 29 | I like puzzles | 0.36 | 0.29 | 0.10 | −0.07 | 0.16 | 0.29 | 0.17 | 0.15 |
| 19 | I act on the spur of the moment | −0.06 | −0.04 | 0.81 | 0.90 | −0.02 | −0.17 | 0.61 | 0.67 |
| 17 | I act “on impulse” | 0.07 | 0.01 | 0.75 | 0.78 | 0.01 | −0.11 | 0.51 | 0.51 |
| 14 | I say things without thinking | 0.07 | 0.09 | 0.68 | 0.64 | −0.06 | −0.09 | 0.37 | 0.33 |
| 18 | I get bored easily when solving thought problems | −0.11 | −0.11 | 0.55 | 0.37 | −0.10 | 0.02 | 0.28 | 0.18 |
| 2 | I do things without thinking | −0.26 | −0.11 | 0.53 | 0.56 | 0.05 | 0.06 | 0.44 | 0.39 |
| 4 | I am happy-go-lucky | −0.17 | −0.17 | 0.45 | 0.49 | 0.17 | 0.20 | 0.53 | 0.46 |
| 5 | I don't “pay attention” | −0.11 | −0.15 | 0.41 | 0.32 | 0.11 | 0.22 | 0.40 | 0.27 |
| 6 | I have “racing” thoughts | 0.13 | 0.12 | 0.48 | 0.37 | 0.12 | 0.15 | 0.30 | 0.22 |
| 3 | I make up my mind quickly | 0.28 | 0.36 | 0.37 | 0.49 | 0.06 | −0.21 | 0.15 | 0.23 |
| 24 | I change hobbies | 0.04 | 0.06 | 0.05 | 0.19 | 0.52 | 0.51 | 0.41 | 0.41 |
| 21 | I change residences | −0.02 | 0.06 | −0.07 | −0.02 | 0.57 | 0.52 | 0.30 | 0.26 |
| 22 | I buy things on impulse | 0.04 | 0.07 | 0.33 | 0.23 | 0.46 | 0.44 | 0.49 | 0.36 |
| 26 | I often have extraneous thoughts when thinking | −0.01 | −0.06 | 0.32 | 0.22 | 0.42 | 0.50 | 0.44 | 0.44 |
| 25 | I spend or charge more than I earn | −0.12 | −0.17 | 0.32 | 0.20 | 0.38 | 0.48 | 0.40 | 0.44 |
| 28 | I am restless at the theater or lectures | −0.10 | −0.09 | −0.10 | −0.22 | 0.91 | 0.98 | 0.73 | 0.76 |
| 11 | I “squirm” plays or lectures | −0.10 | −0.01 | 0.13 | −0.13 | 0.84 | 0.84 | 0.59 | 0.59 |
| 16 | I change jobs | −0.04 | −0.02 | 0.29 | 0.20 | 0.26 | 0.35 | 0.25 | 0.24 |
| 27 | I am more interested in the present than the future | 0.12 | 0.01 | 0.28 | 0.21 | −0.03 | 0.07 | 0.07 | 0.06 |
| 23 | I can only think about one problem at a time | 0.06 | −0.07 | 0.29 | 0.13 | −0.07 | 0.09 | 0.06 | 0.05 |
| Factor determinacies | 0.94 | 0.95 | 0.94 | 0.94 | 0.94 | 0.95 | |||
| Factor correlations | |||||||||
| Impulsive behavior | −0.19 | −0.19 | |||||||
| Impatience | 0.04 | −0.06 | 0.57 | 0.60 | |||||
Note: Sample 1 N = 802; Sample 2 N = 827; Rotation is an oblique type (Promax). Salient factor loadings (≥0.30) are boldfaced. No. of items selected in further models are boldfaced. Boldfaced correlation coefficients are significant at least at P < 0.001.
The EFA was repeated on Sample 2 from CS1 (N = 827). As in Sample 1, here the new three-factor solution also provided the best and most interpretable factor solution (χ2 = 1,189, df = 348, P < 0.0001; RMSEA = 0.054, SRMR = 0.053). The first four eigenvalues for the sample correlation matrix were 6.97, 4.48, 1.70, and 1.45. Factor loadings are presented in Table 3. In the item-selection process, the following rules were followed. Analyses retained items which had loading on the factor larger than 0.50. The exclusion criteria were specified before the analysis. First, items with factor loadings less than 0.30 were excluded in at least one of the two analyses. Second, items with salient cross loadings were excluded. If a cross-loading was identified in only one analysis from the two parallel EFAs, a cutoff of 0.50 was used. In case of more than two cross-loadings, a cutoff of 0.30 was used to exclude items from further analyses. The retained items are emboldened in Table 3. As result of the above criteria, 21 items remained of the original 30 items. We have repeated all analysis with items as ordinal scales and weighted least square mean and variance adjusted WLSMV estimator, we have received similar factor solutions. The Appendix contains the newly created 21-item BIS scale with its evaluation guideline.
The first factor was labeled as cognitive impulsivity and contained ten items. The range of factor loadings was between 0.36 and 0.79 in Sample 1, and 0.29–0.78 in Sample 2. However, due to the predefined selection criteria, nine items of this factor were retained in the final model. These items generally referred to tendencies of planning ahead and focusing on tasks. The second factor was labeled as behavioral impulsivity and contained nine items; however, only five items reached the required level of salient factor loadings in both samples and also satisfied the predefined criteria. The range of factor loadings was between 0.37 and 0.81 in Sample 1 and 0.49–0.90 in Sample 2. The items of this factor generally referred to the immediacy of behavior regardless of its consequences. The third factor was labeled as impatience/restlessness and contained eight items; however, only seven items were retained in the final model due to selection criteria. The range of factor loadings was between 0.29 and 0.91 in Sample 1 and 0.35–0.98 in Sample 2. The items of this factor generally referred to instability of behavior and cognitive functions and the low level of self-regulation.
Correlations between factors reflected the expected directions. The cognitive impulsivity factor consisting of reversed items correlated negatively with the behavioral impulsivity factor (r = −0.19 in Sample 1, and r = −0.19 in Sample 2) and with the impatience/restlessness factor (r = 0.04 n.s. in Sample 1, and r = −0.06 in Sample 2). Behavioral impulsivity and impatience/restlessness factors correlated positively (r = 0.57 in Sample 1, and r = 0.60 in Sample 2). All these correlations supported the requirement of divergent validity indicating that the factors represented different constructs.
Confirmatory factor analysis (CFA) of the new three-factor model
Based on the previous analyses in Samples 1 and 2, a three-factor solution was tested in Sample 3 (N = 828) from the first community sample (CS1). Using items as ordinal scales and applying WLSMV estimation in CFA, we received close to adequate fit (χ2 = 887.9, df = 186, P < 0.0001; CFI = 0.918; TLI = 0.907; RMSEA = 0.068 [0.063–0.072] Cfit < 0.001; SRMR = 0.067). Searching for the partial misfit, large error covariances were identified between Item 11 (“I ‘squirm’ at plays or lectures”) and Item 28 (“I am restless at the theater or lectures”) in the Impatience/restlessness factor. Error covariance reflected the common variance between these items that is not explained by the latent Impatience/restlessness factor. Both items had the shared meaning regarding the tendency not to be calm and patient when indicated or needed. Freeing these error covariances, the degree of model fit became acceptable (χ2 = 689, df = 185, P < 0.001; CFI = 0.941; TLI = 0.933; RMSEA = 0.057 [0.053–0.062] Cfit < 0.004; SRMR = 0.058). Therefore, the final model included 21 items of the original 30 items. The factor loadings and factor correlations are presented in Table 4.
Confirmatory factor analysis of the new measurement model in sample 3, sample of college students and a community sample: standardized factor loadings.
| Item No | Item | Cognitive impulsivity | Behavioral impulsivity | Impatience/restlessness | ||||||
| Sample 3 | College students | Com-munity sample | Sample 3 | College students | Com-munity sample | Sample 3 | College students | Com-munity sample | ||
| Factor loadings | ||||||||||
| 9 | I concentrate easily* | −0.74 | −0.58 | −0.75 | ||||||
| 12 | I am a careful thinker* | −0.74 | −0.78 | −0.80 | ||||||
| 1 | I plan tasks carefully* | −0.71 | −0.74 | −0.74 | ||||||
| 20 | I am a steady thinker* | −0.68 | −0.44 | −0.69 | ||||||
| 8 | I am self-controlled* | −0.67 | −0.58 | −0.70 | ||||||
| 13 | I plan for job security* | −0.60 | −0.44 | −0.60 | ||||||
| 7 | I plan trips well ahead of time* | −0.56 | −0.58 | −0.65 | ||||||
| 30 | I am future oriented* | −0.49 | −0.20 | −0.54 | ||||||
| 10 | I save regularly* | −0.43 | −0.49 | −0.52 | ||||||
| 19 | I act on the spur of the moment | 0.90 | 0.86 | 0.79 | ||||||
| 17 | I act “on impulse” | 0.76 | 0.74 | 0.80 | ||||||
| 2 | I do things without thinking | 0.66 | 0.73 | 0.64 | ||||||
| 14 | I say things without thinking | 0.54 | 0.61 | 0.66 | ||||||
| 18 | I get bored easily when solving thought problems | 0.55 | 0.39 | 0.65 | ||||||
| 25 | I spend or charge more than I earn | 0.76 | 0.58 | 0.75 | ||||||
| 26 | I often have extraneous thoughts when thinking | 0.74 | 0.60 | 0.68 | ||||||
| 22 | I buy things on impulse | 0.69 | 0.53 | 0.70 | ||||||
| 24 | I change hobbies | 0.64 | 0.36 | 0.77 | ||||||
| 28 | I am restless at the theater or lectures | 0.58 | 0.51 | 0.85 | ||||||
| 21 | I change residences | 0.47 | 0.37 | 0.71 | ||||||
| 11 | I “squirm” plays or lectures | 0.53 | 0.42 | 0.73 | ||||||
| Correlations between factors | ||||||||||
| Behavioral impulsivity | 0.41 | 0.66 | 0.26 | |||||||
| Impatience/restlessness | 0.21 | 0.63 | 0.19 | 0.71 | 0.69 | 0.74 | ||||
Note: Sample 3: N = 828; College student sample: N = 765. Community sample: N = 2,040. Boldfaced correlations are significant at least P < 0.001. *: reversed items.
Correlations between the factors ranged from 0.21 to 0.70 (Table 4). Cognitive impulsivity correlated with impatience/restlessness (r = 0.21), and with behavioral impulsivity (r = 0.41). As expected, Behavioral impulsivity correlated positively with Impatience/restlessness (r = 0.65) as well. The indices of internal consistency of each factors were calculated: cognitive impulsivity: Cronbach's α = 0.80 [0.77–0.82], McDonald's ω = 0.81; behavioral impulsivity: Cronbach's α = 0.74 [0.71–0.77], McDonald's ω = 0.76; impatience/restlessness: Cronbach's α = 0.69 [0.66–0.72], McDonald's ω = 0.69.
In order to cross-validate the new measurement model of impulsivity, a CFA analysis was repeated on an independent sample of college students. The newly developed model yielded close to adequate level of fit to this sample (χ2 = 1,363.9, df = 186, P < 0.0001; CFI = 0.833; TLI = 0.811; RMSEA = 0.091 [0.086–0.096], Cfit < 0.001; SRMR = 0.078).
After the inspection of modification indices, one error covariance was freed including between Item 11 (“I ‘squirm’ at plays or lectures”) and Item 28 (“I am restless at the theater or lectures). The degree of fit increased significantly and became closer to be acceptable (χ2 = 1,040.5, df = 185, P < 0.0001, CFI = 0.878; TLI = 0.862, RMSEA = 0.078 [0.073–0.082], Cfit = 0.001, SRMR = 0.067). Similar to the previous sample, correlations between the factors ranged from 0.63 to 0.71 (Table 4). Cognitive impulsivity strongly correlated with impatience/restlessness (r = 0.63), and with behavioral impulsivity (r = 0.66). As expected, behavioral impulsivity also correlated with impatience/restlessness (r = 0.71). We tested the internal consistency of the factors in this sample: cognitive impulsivity: Cronbach's α = 0.81 [0.80–0.82], McDonald's ω = 0.82; behavioral impulsivity: Cronbach's α = 0.72 [0.71–0.74], McDonald's ω = 0.74; impatience/restlessness: Cronbach's α = 0.68 [0.66–0.70], McDonald's ω = 0.68.
For further cross-validation, the new shorter version of the BIS was administered in a large, representative community sample. The newly developed model yielded adequate level of fit to this sample (χ2 = 1,021.1, df = 186, P < 0.0001; CFI = 0.949; TLI = 0.942; RMSEA = 0.049 [0.046–0.051], Cfit < 0.796; SRMR = 0.058). After the inspection of modification indices, one error covariance was freed including between Item 11 (“I ‘squirm’ at plays or lectures”) and Item 28 (“I am restless at the theater or lectures”). The degree of fit increased significantly and demonstrated a good fit (χ2 = 974.2, df = 185, P < 0.0001, CFI = 0.952; TLI = 0.945, RMSEA = 0.047 [0.044–0.050], Cfit = 0.935, SRMR = 0.057). We also tested the internal consistency of the factors in this sample as well: cognitive impulsivity: Cronbach's α = 0.84 [0.83–0.85], McDonald's ω = 0.84; behavioral impulsivity: Cronbach's α = 0.77 [0.75–0.88], McDonald's ω = 0.77; impatience/restlessness: Cronbach's α = 0.81 [0.80–0.82], McDonald's ω = 0.81.
Construct validity of the three-factor model of impulsivity in a community sample
To examine the construct validity of the three-factor impulsivity model in the community sample, the present study first examined the correlations of the new factors of impulsivity with the subscales of the BSI, and second the associations were tested between the new three factors and gender, age, and behavioral indicators including smoking, indicators of alcohol use, and exercise behaviors. The correlations between the impulsivity factors and BSI are presented in Table 5. Here, we also applied Bonferroni correction in order to avoid the inflated Type I error. The Global Severity Index and Obsessive-Compulsive scale showed positive correlations with cognitive impulsivity, while the Paranoid Ideation scale showed moderate negative correlations with cognitive impulsivity. The behavioral impulsivity factor was positively correlated with the Global Severity Index, Obsessive-Compulsive, Hostility, and Psychoticism scales, and negatively correlated with Somatization and Anxiety. The impatience/restlessness factor had positive and significant correlations with the Global Severity Index, Hostility, and Psychoticism scales, and had negative and significant correlations with Somatization and Anxiety scales.
Correlations between new factors of impulsivity and global severity index and subscales of Brief Symptom Inventory.
| Cognitive impulsivity | Behavioral impulsivity | Impatience/restlessness | |
| Global Severity Index | 0.32 | 0.33 | 0.37 |
| Subscales of Brief Symptom Inventory | |||
| Somatization | −0.09 | −0.13 | −0.20 |
| Obsessive-Compulsive | 0.69 | 0.31 | −0.07 |
| Interpersonal Sensitivity | 0.06 | 0.18 | −0.01 |
| Depression | 0.05 | −0.10 | −0.08 |
| Anxiety | −0.07 | −0.33 | −0.43 |
| Hostility | 0.06 | 0.28 | 0.25 |
| Phobic Anxiety | −0.02 | −0.05 | 0.13 |
| Paranoid Ideation | −0.25 | −0.00 | 0.10 |
| Psychoticism | 0.03 | 0.22 | 0.45 |
Note: N = 2,632; After the Bonferroni correction, the correlations that are significant at least at P < 0.0017 are boldfaced.
In order to test the associations between the three factors and behavioral indicators, a CFA was performed with covariates. This is sometimes called the multiple indicators and multiple causes (MIMIC) model in which the impact of covariates on latent variables are estimated simultaneously. The partial standardized regression coefficients are presented in Table 6. In the evaluation of the coefficients, we used a stricter criterion for significance according to Bonferroni correction for multiple testing. No gender-related differences were found in the three factors of impulsivity. Age was negatively associated with cognitive impulsivity, behavioral impulsivity and impatience/restlessness. As expected, cognitive impulsivity was negatively associated with exercise and positively associated with substance use including smoking and binge drinking. Behavioral impulsivity – again, as expected – was positively associated with smoking and binge drinking, but not with exercise. Finally, impatience/restlessness was positively associated with binge drinking. We also tested the incremental validity of the three factors of impulsivity in a multivariate predictor model in which the behavioral indicators were the outcomes and the three factors were the predictors. Cognitive impulsivity was the strongest predictor of all four indicators. Higher cognitive impulsivity was related with lower probability of regular exercise, higher likelihood of smoking and binge drinking, and higher frequency of alcohol use while the other two factors were controlled. Behavioral impulsivity also significantly predicted cigarette smoking, alcohol use, and binge drinking, but in these cases the significance levels of the coefficients were below the stricter criterion based on Bonferroni correction.
The association between the three factors of impulsivity and gender, age, regular exercise, smoking and alcohol use in a CFA with covariates analysis: Standardized regression coefficients.
| Cognitive impulsivity | Behavioral impulsivity | Impatience/restlessness | ||
| MIMIC model | ||||
| Gender | 0.04 | 0.06 | −0.02 | |
| Age | −0.01** | −0.01** | −0.02*** | |
| Regular exercise | −0.31*** | −0.06 | 0.12 | |
| Smoking status | 0.21*** | 0.23*** | 0.13* | |
| Alcohol use in the last 30 days | 0.01** | 0.01** | <0.01 | |
| Binge drinking | 0.46*** | 0.46*** | 0.38*** | |
| R2 (%) | 5.4 | 6.6 | 10.1 | |
| Multivariate predictor modela | ||||
| Cognitive impulsivity | Behavioral impulsivity | Impatience/restlessness | R2 (%)b | |
| Regular exercise | −0.26*** | −0.05 | 0.13** | 5.6% |
| Smoking status | 0.16*** | 0.15** | −0.03 | 4.7% |
| Alcohol use in the last 30 days | 0.84*** | 0.70* | −0.20 | 1.6% |
| Binge drinking | 0.30*** | 0.16* | 0.07 | 12.3% |
Note: N = 2,409; *P < 0.05; **P < 0.01; ***P < 0.001. Boldfaced coefficients are significant at P < 0.0028 (Bonferroni correction for multiple testing).
Age and gender are controlled.
Calculated without age and gender.
Construct validity of the three-factor model of impulsivity in a college sample: A CFA with covariates model
To lend further support to the construct validity of the new three-factor model of impulsivity in another independent sample, univariate analyses and a CFA were performed with covariates in the college sample. Associations were tested between the three factors of impulsivity and the subscales of the Buss-Perry Aggression Questionnaire including verbal aggression, physical aggression, anger, and hostility. The standardized regression coefficients in univariate analyses and the partial standardized regression coefficients in the CFA with covariates analysis are presented in Table 7. In the univariate analyses, verbal aggression, physical aggression, anger, and hostility were significantly and positively associated with the cognitive impulsivity, behavioral impulsivity and impatience/restlessness factors. In the multivariate analyses, cognitive impulsivity, behavioral impulsivity, and impatience/restlessness were positively associated with verbal aggression. Comparisons of coefficients revealed that behavioral impulsivity had a stronger association with verbal aggression than the other two factors. Behavioral impulsivity was also significantly associated with physical aggression, and impatience/restlessness was positively associated with hostility.
The associations between three factors of impulsivity and aggression hostility in college students
| Cognitive impulsivity | Behavioral impulsivity | Impatience/restlessness | |
| Univariate predictors | |||
| Gender | 0.05 | 0.08* | 0.11** |
| Age | 0.01 | −0.03. | −0.01 |
| Verbal aggression | 0.22*** | 0.43*** | 0.27*** |
| Physical aggression | 0.14*** | 0.28*** | 0.16*** |
| Anger | 0.18*** | 0.23*** | 0.29*** |
| Hostility | 0.17** | 0.18*** | 0.36*** |
| Multivariate predictor model | |||
| Gender | 0.06 | 0.14** | 0.12** |
| Age | 0.07 | −0.05 | 0.02 |
| Verbal aggressiona | 0.15***a | 0.34***b | 0.14**a |
| Physical aggression | 0.08 | 0.21*** | 0.13** |
| Anger | 0.06 | <0.01 | 0.06 |
| Hostility | 0.09 | 0.09 | 0.28*** |
| R2 (%) | 7.4 | 23.9 | 18.6 |
Note: N = 769. *P < 0.05; **P < 0.01; ***P < 0.001. Boldfaced coefficients are significant at P < 0.0028 (Bonferroni correction for multiple testing). #: Pairwise comparisons of the regression coefficients are presented with subscript letters. Parameters sharing the similar subscript are not significantly different. Behavioral impulsivity has a significantly stronger association (P < 0.001) with verbal aggression than the other two factors
Discussion
The originally proposed factor structure of the Barratt Impulsivity Scale (BIS-11) was not supported in two independent large samples. However, the present study created a new, alternative three-dimensional measurement model for impulsivity based on a series of exploratory and confirmatory factor analyses. Three factors were identified comprising (i) cognitive impulsivity, (ii) behavioral impulsivity, and (iii) impatience/restlessness. Additionally, the number of items was reduced from 30 to 21, and these items appear to define the self-reported impulsivity construct more concisely. This factor structure was confirmed in further two independent samples.
The first factor – labeled as cognitive impulsivity – integrates those reversed items that refer to the lack of planning, instability and emotional imbalance. It includes nine items, six of which stem from the original Non-planning Impulsiveness factor, two from the Attentional Impulsiveness factor, and one from the Motor Impulsiveness factor. However, the correlations between cognitive impulsivity and the other two factors were relatively weak. Labeling this factor, we followed the original naming. However, here we would emphasize that this factor can be seen as a reversed self-control (low self-control) factor. The construct of impulsivity and self-control are sometimes treated as different constructs and sometimes as a continuum from impulsivity (low self-control) to high self-control (Duckworth & Kern, 2011). For example, the correlation between impulsivity assessed using the BIS-11 correlates very strongly with self-control measures (r = −0.72; Mao et al., 2018). The second factor was labeled as behavioral impulsivity, and reflects a form of impulsivity which has a mainly behavioral manifestation. It is closely related to the original Motor Impulsiveness factor in that three of its five items derive from it. However, it also contains two items of the original Non-planning Impulsiveness (one item from the Self-control and one from the Cognitive Complexity first order factors). The third factor was labeled as impatience/restlessness and refers to difficulties in concentrating on tasks or implementing behavior in wider contexts, including being restless in different situations. This factor includes seven items, with three items from the former Motor Impulsiveness factor and four items from the Attentional Impulsiveness factor (two items from the Attention and two from the Cognitive Instability sub-factors). Considering the conceptual basis of the proposed three-factor model, cognitive and behavioral impulsivity might be well interpreted within the conceptual framework of Barratt and Stanford (1995), while in case of impatience/restlessness – following a content analysis of its items - we could state that this factor might mostly be related to lack of perseverance. None of these factors can be explained or interpreted by further models and facets of impulsivity (e.g. Depue & Collins, 1999; Whiteside & Lynam, 2001). The BIS-11 factors in their original structure mainly fit under the umbrella of the UPPS model's (lack of) premeditation construct, additional facets of impulsivity (such as boredom susceptibility, urgency) are therefore simply better identified by other models and measures which indicates the aforementioned limits of BIS-11. Our factorial solution is not consistent with any other previous models which again highlights the diversity of impulsivity as assessed using the BIS scale across different samples.
The earlier outlined associations between impulsivity and mental and behavioral disorders suggest that the BSI designed to evaluate psychological problems might be suitable in estimating the construct validity of the alternative three-factor model. However, it needs to be noted that specific behavioral indicators showed significant associations with more than one impulsivity factor. This result is not in support of the validity of the proposed model. CFA with covariates analysis conducted on the community sample showed a significant effect of the Global Severity Index of the BSI on all three factors of the new model. All three factors had consistent positive associations with the Global Severity Index, illustrating the role of impulsivity in various psychiatric conditions, consistent with the approach of the NIMH Research Domain Criteria (RDoC) (Insel, 2014).
Furthermore, results demonstrated different patterns of symptoms and among the new three factors of impulsivity. Obsessive-compulsive symptoms were related with cognitive impulsivity and behavioral impulsivity in accordance with previous findings that people suffering from obsessive-compulsive disorders show higher attentional impulsivity score (Sahmelikoglu Onur et al., 2016). However, this association can be explained with cognitive and behavioral impulsivity components. Hostility was related with behavioral impulsivity and impatience/restlessness among the large community sample. However, among the college sample, hostility was associated with impatience/restlessness only in the multivariate analysis. These results are in accordance with a previous study which presented evidence that hostility correlates with attentional and motor impulsivity (Menon, Sarkar, Kattimani, & Mathan, 2015). Furthermore, our study found that impatience/restlessness may be a component through which hostility is related with impulsivity. The present study also tested the effect of a number of behavioral data on the newly established factors. Regular exercise had a negative association only with cognitive impulsivity which is in accordance with the assumption that regular exercise requires self-control and planning (Englert, 2016; Finne et al., 2019). The associations between impulsivity and substance use including cigarette smoking (Kale et al., 2018) and alcohol use (Dick et al., 2010) are well documented. In our study, cognitive impulsivity concurrently predicted smoking, alcohol use, and binge drinking while controlling for two other factors of impulsivity. Behavioral impulsivity also concurrently predicted substance use. However, the effect size of the coefficients were much smaller.
As a further step in testing construct validity, we tested the associations between aggressive behaviors and the three factors of impulsivity. The association between impulsivity and aggression has been widely studied in the literature, with implications of overlapping genetic background (Seroczynski, Bergeman, & Coccaro, 1999), and molecular psychobiological mechanisms (Lesch & Merschdorf, 2000). Furthermore, the construct of impulsive aggression reflects the interconnected nature of these dimensions. The results of the present study indicated significant covariances of the Buss Perry Aggression Questionnaire scales with all factors of the alternative model of the BIS-11. The directions of these effects were in accordance with the content of the factors. More specifically, verbal and physical aggression were associated more strongly with behavioral impulsivity than the other two components of impulsivity, and hostility was associated only with impatience/restlessness.
To interpret our results by using RDoC units of analysis, the construct of impulsivity as measured by the BIS-R-21 might be characterized by a) a tendency to act with less forethought than the majority of the individuals with equal knowledge and ability, b) a predisposition toward unplanned reactions to either internal or external stimuli; c) lack of considering potential negative consequences of one's acts; d) a persistent pattern of inattention; e) a pattern of hyperactivity; and f) impaired decision making. These aspects of impulsivity are often linked to the etiology and symptomatology of various psychiatric disorders, including addictions (Brooks, Lochner, Shoptaw, & Stein, 2017). Considering the five major domains of RDoC (i.e. negative valence, positive valence, cognitive, social and arousal & regulation), impaired cognitive control, lack of attention and disinhibition (all from the Cognitive domain) are main hallmark of the BIS-R-21 measured impulsivity construct.
The results of the present study further indicate that instead of the original 30-item version, an abbreviated 21-item version of BIS-11 shows better psychometric properties. A shortened version of the instrument was also recommended by Spinella (2007), named BIS-15 (containing 15 items), which is now available in English, German (Meule, Vögele, & Kübler, 2011) and Spanish (Orozco-Cabal, Rodriguez, Herin, Gempeler, & Uribe, 2010). Further examination of the reliability and validity of this novel version – named the 21-item Barratt Impulsiveness Scale Revised (BIS-R-21) – is suggested for both clinical and non-clinical settings.
Limitations and future research
The present study is not without limitations. A mixed sample was assessed, with two community samples being representative to the Hungarian adult population, while the Hungarian college sample – recruited via convenience sampling – was a non-probability sample. Language and culture may have severe impact on interpreting each items (Vasconcelos et al. 2012). Therefore, it is still not clear if the results presented here are generalizable to other countries and language versions of this scale. The relevance of the content of each item may also vary in different age groups. Some items may have different meanings for adults compared to university students. This may explain the structural instability in different age groups. Furthermore, the severity of psychoactive substance use was not measured by commonly applied validated instruments, such as the Alcohol Use Disorder Identification Test (AUDIT) for alcohol (Babor, Higgins-Biddle, Saunders, & Monteiro, 2001), or the Fagerström Test for Nicotine Dependence (Heatherton, Kozlowski, Frecker, & Fagerström 1991) for smoking severity. Construct validity was tested by correlating the three factors with similar self-reported scales (e.g., Brief Symptom Inventory, Buss-Perry Aggression Questionnaire), but not with other levels of assessment, such as continuous performance tests or other behavioral assessments of impulsivity (e.g. Hamilton et al., 2015a, 2015b).
In order to better define the construct impulsivity and its components, future research is needed to reanalyze the factor structure by using a larger pool of impulsivity items rather than the brief version of the BIS scale, as it was done in the development of the UPPS-P (Whiteside & Lynam, 2001) and other recent disinhibition scales. New and potentially more precise factor labels might also be derived from further studies that compare the presented three factors with other self-reported impulsivity measures (see Table 1) and/or clinical diagnoses (e.g., ADHD or impulse control disorders). This would help in reaffirming these labels and may lead to their refinement in terms of their name, nature and interpretation.
Conclusions
The newly presented measurement model of impulsivity was confirmed in two independent samples. However, it requires further cross-cultural validation to clarify the content of self-reported impulsivity. Its construct validity needs additional testing by comparing BIS-R-21 results with those obtained via other methods.
Funding sources
This work was supported by the Hungarian National Research, Development and Innovation Office (Grant numbers: K111938, KKP126835, K109375) and by the Hungarian Ministry of Social Affairs and Labor (grant number: KAB-KT-09-0007).
Máté Kapitány-Fövény, Gyöngyi Kökönyei and Bernadette Kun acknowledge the financial support of the János Bolyai Research Fellowship awarded by the Hungarian Academy of Sciences. Máté Kapitány-Fövény acknowledges the support by the ÚNKP-19-4 New National Excellence Program of the Ministry for Innovation and Technology. Anna Szekely acknowledges the financial support of the Hungarian Academy of Sciences (awarded to the MTA-ELTE Lendület Adaptation Research Group – project number: LP-2018-21/2018). Marc Potenza acknowledges the receipt of support from the National Institute on Drug Abuse (R01 DA035058), the Connecticut Council on Problem Gambling, the Connecticut Department of Mental Health and Addiction Services, and the National Center for Responsible Gaming (Center of Excellence in Gambling Research Award).
Authors' contribution
All authors discussed the results and contributed to the final version of the manuscript. M. K-F., G.V., A.Sz., B.P., B.K., J.F. and Gy.K. were involved in writing the theoretical background and the discussion sections of the manuscript, R.U. was responsible for statistical analyses and interpretation of their results, Z.D., M.N.P., and M.D.G. helped in supervising the project and proofreading the manuscript.
Conflict of interest
The authors declare no conflict of interest.
The 21-item Barratt Impulsiveness Scale Revised (BIS-R-21)
| Response categories | |||||
| Rarely never/Never | Occasionally | Often | Almost always/Always | ||
| 1 | I plan tasks carefully | 1 | 2 | 3 | 4 |
| 2 | I plan trips well ahead of time | 1 | 2 | 3 | 4 |
| 3 | I do things without thinking | 1 | 2 | 3 | 4 |
| 4 | I “squirm” at plays or lectures | 1 | 2 | 3 | 4 |
| 5 | I am self-controlled | 1 | 2 | 3 | 4 |
| 6 | I concentrate easily | 1 | 2 | 3 | 4 |
| 7 | I say things without thinking | 1 | 2 | 3 | 4 |
| 8 | I change residences | 1 | 2 | 3 | 4 |
| 9 | I save regularly | 1 | 2 | 3 | 4 |
| 10 | I act “on impulse” | 1 | 2 | 3 | 4 |
| 11 | I buy things on impulse | 1 | 2 | 3 | 4 |
| 12 | I am a careful thinker | 1 | 2 | 3 | 4 |
| 13 | I get easily bored when solving thought problems | 1 | 2 | 3 | 4 |
| 14 | I change hobbies | 1 | 2 | 3 | 4 |
| 15 | I plan for job security | 1 | 2 | 3 | 4 |
| 16 | I act on the spur of the moment | 1 | 2 | 3 | 4 |
| 17 | I spend or charge more than I earn | 1 | 2 | 3 | 4 |
| 18 | I am a steady thinker | 1 | 2 | 3 | 4 |
| 19 | I often have extraneous thoughts when thinking | 1 | 2 | 3 | 4 |
| 20 | I am future oriented | 1 | 2 | 3 | 4 |
| 21 | I am restless at the theater or lectures | 1 | 2 | 3 | 4 |
Scoring:
(1) Cognitive impulsivity (the sum of the reversed items 1*, 2*, 5*, 6*, 9*, 12*, 15*, 18*, 20*)
(2) Behavioral impulsivity (the sum of the items 3, 7, 10, 13, 16)
(3) Impatience/restlessness (the sum of the items 4, 8, 11, 14, 17, 19, 21)
Note: The factor ‘Cognitive impulsivity’ shows weak correlation with both ‘Behavioral impulsivity’ and ‘Impatience/restlessness’. This needs to be considered when interpreting impulsivity as the total score of BIS-R-21.
A 21 tételes Módosított Barratt Impulzivitás Skála (BIS-R-21)
| Válaszkategóriák | |||||
| Soha/Ritkán | Néha | Gyakran | Majdnem mindig/Mindig | ||
| 1 | Gondosan megtervezem a feladataimat. | 1 | 2 | 3 | 4 |
| 2 | Jó előre megtervezem az utazásaimat. | 1 | 2 | 3 | 4 |
| 3 | Gondolkodás nélkül cselekszem. | 1 | 2 | 3 | 4 |
| 4 | Fészkelődöm olyankor, amikor hosszabb ideig csendben, ülve kellene maradnom. | 1 | 2 | 3 | 4 |
| 5 | Nagy az önuralmam. | 1 | 2 | 3 | 4 |
| 6 | Könnyen tudok koncentrálni a dolgokra. | 1 | 2 | 3 | 4 |
| 7 | Gondolkodás nélkül kimondom a dolgokat. | 1 | 2 | 3 | 4 |
| 8 | Váltogatom a lakhelyeimet. | 1 | 2 | 3 | 4 |
| 9 | Rendszeresen teszek félre pénzt. | 1 | 2 | 3 | 4 |
| 10 | Gondolkodás nélkül, az első benyomásom alapján, azonnal cselekszem. | 1 | 2 | 3 | 4 |
| 11 | Hirtelen ötlettől vezérelve vásárolok. | 1 | 2 | 3 | 4 |
| 12 | Alaposan át szoktam gondolni a dolgokat. | 1 | 2 | 3 | 4 |
| 13 | Könnyen megunom az elméleti kérdéseken való töprengést. | 1 | 2 | 3 | 4 |
| 14 | Váltogatom a hobbijaimat. | 1 | 2 | 3 | 4 |
| 15 | Stabil munkahelyre törekszem. | 1 | 2 | 3 | 4 |
| 16 | A pillanat hevében cselekszem. | 1 | 2 | 3 | 4 |
| 17 | Többet költök, mint amennyit keresek. | 1 | 2 | 3 | 4 |
| 18 | Kitartó gondolkodó vagyok. | 1 | 2 | 3 | 4 |
| 19 | Gondolkodás közben elkalandozik a figyelmem. | 1 | 2 | 3 | 4 |
| 20 | Foglalkoztat a jövő. | 1 | 2 | 3 | 4 |
| 21 | Nyugtalanná válok, amikor csendben, ülve kellene maradnom. | 1 | 2 | 3 | 4 |
Pontozás:
(1) Kognitív impulzivitás (az alábbi fordított tételek összege: 1*, 2*, 5*, 6*, 9*, 12*, 15*, 18*, 20*)
(2) Viselkedési impulzivitás (az alábbi tételek összege: 3, 7, 10, 13, 16)
(3) Türelmetlenség/nyugtalanság (az alábbi tételek összege: 4, 8, 11, 14, 17, 19, 21)
Megjegyzés: A ‘kognitív impulzivitás’ faktora gyenge korrelációt mutat mind a ‘viselkedési impulzivitás’, mind a ‘türelmetlenség/nyugtalanság’ faktorokkal. Ezt érdemes figyelembe venni, amikor a BIS-R-21 összpontszámaként értelmezzük az impulzivitás konstruktumát.
References
Adawi, M., Zerbetto, R., Re, T. S., Bisharat, B., Mahamid, M., Amital, H., et al. (2019). Psychometric properties of the brief symptom inventory in nomophobic subjects: Insights from preliminary confirmatory factor, exploratory factor, and clustering analyses in a sample of healthy Italian volunteers. Psychology Research and Behavior Management, 12, 145–154.
Alvarez-Moya, E. M., Ochoa, C., Jiménez-Murcia, S., Aymamí, M. N., Gómez-Peña, M., Fernández-Aranda, F., et al. (2011). Effect of executive functioning, decision-making and self-reported impulsivity on the treatment outcome of pathologic gambling. Journal of Psychiatry & Neuroscience, 36(3), 165–175.
Babor, T. F., Higgins-Biddle, J. C., Saunders, J. B., & Monteiro, M. G. (2001). The alcohol use disorders identification test, guidelines for use in primary care (2nd ed.). Geneva, Switzerland: World Health Organization.
Barkley, R. A. (1997). Behavioral inhibition, sustained attention, and executive functions: Constructing a unifying theory of ADHD. Psychological Bulletin, 121(1), 65–94.
Barratt, E. S. (1965). Anxiety and impulsiveness related to psychomotor efficiency. Perceptual & Motor Skills, 9, 191–198.
Barratt, E. S., & Stanford, M. S. (1995). Impulsiveness. In C. G. Costello (Ed.), Personality characteristics of the personality disordered (pp. 91–119). New York: Wiley.
Beaton, D. E., Bombardier, C., Guillemin, F. & Ferraz, M. B. (2000). Guidelines for the process of cross-cultural adaptation of self-report measures. Spine, 25(24), 3186–3191.
Bénard, M., Camilleri, G. M., Etilé, F., Méjean, C., Bellisle, F., Reach, G., et al. (2017). Association between impulsivity and weight status in a general population. Nutrients, 9(3), 217.
Bender, L. (1938). A visual motor gestalt test and its clinical use (research monograph No. 3). New York: American Orthopsychiatric Association.
Berg, J. M., Latzman, R. D., Bliwise, N. G., & Lilienfeld, S. O. (2015). Parsing the heterogeneity of impulsivity: A meta-analytic review of the behavioral implications of the UPPS for psychopathology. Psychological Assessment, 27(4), 1129–1146.
Blaszczynski, A., Steel, Z., & McConaghy, N. (1997). Impulsivity in pathological gambling: The antisocial impulsivist. Addiction, 92(1), 75–87.
Bousardt, A. M. C., Noorthoorn, E. O., Hoogendoorn, A. W., Nijman, H. L. I., & Hummelen, J. W. (2018). On the link between emotionally driven impulsivity and aggression: Evidence from a validation study on the Dutch UPPS-P. International Journal of Offender Therapy and Comparative Criminology, 62(8), 2329–2344.
Brooks, S. J., Lochner, C., Shoptaw, S., & Stein, D. J. (2017). Using the research domain criteria (RDoC) to conceptualize impulsivity and compulsivity in relation to addiction. Progress in Brain Research, 235, 177–218.
Brown, T. A. (2006). Confirmatory factor analysis for applied research. New York: The Guilford Press.
Buss, A. H., & Perry, M. (1992). The aggression questionnaire. Journal of Personality and Social Psychology, 63 ,452–459.
Buss, A. H., & Plomin, R. (1975). A temperament theory of personality development. New York: John Wiley & Sons.
Canale, N., Vieno, A., Griffiths, M. D., Rubaltelli, E., & Santinello, M. (2015). How do impulsivity traits influence problem gambling through gambling motives? The role of perceived gambling risk/benefits. Psychology of Addictive Behaviors, 29, 813–823.
Carver, C. S., & White, T. L. (1994). Behavioral inhibition, behavioral activation, and affective responses to impending reward and punishment: The BIS/BAS scales. Journal of Personality and Social Psychology, 67, 319–333.
Chamberlain, S. R., Stochl, J., Redden, S. A., & Grant, J. E. (2018). Latent traits of impulsivity and compulsivity: Toward dimensional psychiatry. Psychological Medicine, 48(5), 810–821.
Cloninger, C. R. (1987). A systematic method for clinical description and classification of personality variants. Archives of General Psychiatry, 44, 573–588.
Conway, K. P., Kane, R. J., Ball, S. A., Poling, J. C., & Rounsaville, B. J. (2003). Personality, substance of choice, and polysubstance involvement among substance dependent patients. Drug and Alcohol Dependence, 71(1), 65–75.
Costa, P. T., Jr., & McRae, R. R. (1985). The NEO personality inventory manual. Odessa, FL: Psychological Assessment Resources.
Coumans, J. M. J., Danner, U. N., Intemann, T., De Decker, A., Hadjigeorgiou, C., Hunsberger, M., et al. (2018). Emotion-driven impulsiveness and snack food consumption of European adolescents: Results from the I.Family study. Appetite, 123, 152–159.
Cyders, M. A, & Smith, G. T. (2008). Emotion-based dispositions to rash action: Positive and negative urgency. Psychological Bulletin, 134(6), 807–828.
Demırtaş Madran, H. A. (2013). [The reliability and validity of the Buss-Perry aggression questionnaire (BAQ)-Turkish version]. Türk Psikiyatri Dergisi, 24(2), 124–129.
Depue, R. A., & Collins, P. F. (1999). Neurobiology of the structure of personality: Dopamine, facilitation of incentive motivation, and extraversion. Behavioral and Brain Sciences, 22(3), 491–569.
Derogatis, L. R. (1983). SCL-90-R. Administration, scoring and procedures manual. Baltimore: Clinical Psychometric Research.
Derogatis, L. R., & Savitz, K. L. (2000). The SCL-90-R and the brief symptom inventory (BSI) in primary care. In M. E. Maruish (Ed.), Handbook of psychological assessment in primary care settings. Mahwah, NJ: Lawrence Erlbaum Associates.
Derogatis, L. R., & Spencer, M. S. (1982). The brief symptom inventory (BSI): Administration, scoring, and procedures manual-I. Baltimore, MD: Johns Hopkins University School of Medicine, Clinical Psychometrics Research Unit.
Dick, D. M., Smith, G., Olausson, P., Mitchell, S. H., Leeman, R. F., O’Malley, S. S., et al. (2010). Understanding the construct of impulsivity and its relationship to alcohol use disorders. Addiction Biology, 15(2), 217–226.
Dickman, S. J. (1990). Functional and dysfunctional impulsivity: Personality and cognitive correlates. Journal of Personality and Social Psychology, 58(1), 95–102.
Dougherty, D. M. (1999). IMT/DMT immediate memory task and delayed memory task: A research tool for studying attention and memory processes (Version 2.0) [Computer software & manual]. Houston: Neurobehavioral Research Laboratory and Clinic, University of Texas Houston Health Science Center.
Dougherty, D. M., Bjork, J. M., Huckabee, H. C. G., Moeller, F. G., & Swann, A. C. (1999). Laboratory measures of aggression and impulsivity in women with borderline personality disorder. Psychiatry Research, 85(3), 315–326.
Duckworth, A. L., & Kern, M. L. (2011). A meta-analysis of the convergent validity of self-control measures. Journal of Research in Personality, 45(3), 259–268.
Ellouze, F., Ghaffari, O., Zouari, O., Zouari, B., & M'rad, M. F. (2013). [Validation of the dialectal Arabic version of Barratt's impulsivity scale, the BIS-11]. L’Encephale, 39, 13–18.
Englert, C. (2016). The strength model of self-control in sport and exercise Psychology. Frontiers in Psychology, 7, 314.
Eysenck, S. B. G., & Eysenck, H. J. (1977). The place of impulsiveness in a dimensional system of personality. British Journal of Social & Clinical Psychology, 16, 57–68.
Eysenck, S. B. G., Pearson, P. R., Easting, G., & Allsopp, J. F. (1985). Impulsiveness and venturesomeness: Their position in a dimensional system of personality description. Personality and Individual Differences, 6, 613–619.
Finne, E., Englert, C., & Jekauc, D. (2019). On the importance of self-control strength for regular physical activity. Psychology of Sport and Exercise, 43, 165–171.
Finney, S. J., & DiStefano, C. (2006). Nonnormal and categorical data in structural equation modeling. In: G. R. Hancock, & R. D. Mueller (Eds.), Structural equation modeling: A second course (pp. 269–314). Greenwich: Information Age.
Fossati, A., Di Ceglie, A., Acquarini, E., & Barratt, E. S. (2001). Psychometric properties of an Italian version of the Barratt impulsiveness scale-11 (BIS-11) in nonclinical subjects. Journal of Clinical Psychology, 57(6), 815–828.
García-Forero, C., Gallardo-Pujol, D., Maydeu-Olivares, A., & Andrés-Pueyo, A. (2009). Disentangling impulsiveness, aggressiveness and impulsive aggression: An empirical approach using self-report measures. Psychiatry Research, 168(1), 40–49.
Gerevich, J., Bácskai, E., & Czobor, P. (2007). The generalizability of the Buss-Perry aggression questionnaire. International Journal of Methods in Psychiatric Research, 16(3), 124–136.
Golden, C. J. (1978). Stroop-color word test: A manual for clinical use and experimental use. Chicago, IL: Stoleting.
Grace, J., & Malloy, P. F. (2001). Frontal systems behavior scale. Professional manual. Lutz, FL: Psychological Assessment Resources.
Grant, J. E., & Potenza, M. N. (2006). Compulsive aspects of impulse-control disorders. Psychiatric Clinics of North America, 29(2), 539–551.
Güleç, H., Tamam, L., Güleç, M. Y., Turhan, M., Karakuş, G., Zengin, M., et al. (2008). Psychometric properties of the Turkish version of the Barratt impulsiveness scale-11. Klinik Psikofarmakoloji Bulteni - Bulletin of Clinical Psychopharmacology, 18, 251–258.
Haden, S. C., & Shiva, A. (2009). A comparison of factor structures of the Barratt impulsiveness scale in a mentally ill forensic inpatient sample. International Journal of Forensic Mental Health, 8, 198–207.
Hamilton, K. R., Littlefield, A. K., Anastasio, N. C., Cunningham, K. A., Fink, L. H., Wing, V. C., et al. (2015a). Rapid-response impulsivity: Definitions, measurement issues, and clinical implications. Personality Disorders: Theory, Research, and Treatment, 6, 168–181.
Hamilton, K. R., Mitchell, M. R., Wing, V. C., Balodis, I. M., Bickel, W. K., Fillmore, M., et al. (2015b). Choice impulsivity: Definitions, measurement issues, and clinical implications. Personality Disorders, 6, 182–198.
Heatherton, T. F., Kozlowski, L. T., Frecker, R. C., & Fagerström, K. O. (1991). The Fagerström test for nicotine dependence: A revision of the Fagerström tolerance questionnaire. British Journal of Addiction, 86, 1119–1127.
Heaton, R. K., Chelune, G. J., Talley, J. L., Kay, G. G., & Curtiss, G. (1993). Wisconsin card sorting Test manual – Revised and expanded. Lutz, FL: Psychological Assessment Resource, Inc.
Heffner, J. L., Fleck, D. E., DelBello, M. P., Adler, C. M., & Strakowski, S. M. (2012). Cigarette smoking and impulsivity in bipolar disorder. Bipolar Disorders, 14(7), 735–742.
Hirschtritt, M. E., Potenza, M. N., & Mayes, L. C. (2012). Impulsivity and co-occurring psychiatric disorders. In: E. Grant, & M. N. Potenza (Eds.). The Oxford handbook of impulse control disorders (pp. 80–93).Oxford and New York: Oxford University Press.
Insel, T. R. (2014). The NIMH research domain criteria (RDoC) project: Precision medicine for psychiatry. American Journal of Psychiatry, 171(4), 395–397.
Ireland, J. L., & Archer, J. (2008). Impulsivity among adult prisoners: A confirmatory factor analysis study of the Barratt impulsivity scale. Personality and Individual Differences, 45, 286–292.
Jakubczyk, A., Klimkiewicz, A., Topolewska-Wochowska, A., Serafin, P., Sadowska-Mazuryk, J., Pupek-Pyzioł, J., et al. (2012). Relationships of impulsiveness and depressive symptoms in alcohol dependence. Journal of Affective Disorders, 136(3), 841–847.
Kafka, M. P. (1996). Therapy for sexual impulsivity: The paraphilias and paraphilia-related disorders. Psychiatric Times, 13(6), 1–6.
Kafka, M. P. (2003). The monoamine hypothesis for the pathophysiology of paraphilic disorders: An update. Annals of the New York Academy of Sciences, 989, 86–94.
Kagan, J., Rosman, B. L., Day, D., Albert, J., & Phillips, W. (1964). Information processing in the child: Significance of analytic and reflective attitudes. Psychological Monographs, 78(1), 1–37.
Kale, D., Stautz, K., & Cooper, A. (2018). Impulsivity related personality traits and cigarette smoking in adults: A meta-analysis using the UPPS-P model of impulsivity and reward sensitivity. Drug and Alcohol Dependence, 185, 149–167.
Kim, S. T, Hwang, S. S., Kim, H. W., Hwang, E. H., Cho, J., & Kang, J. I., et al. (2018). Multidimensional impulsivity as a mediator of early life stress and alcohol dependence. Scientific Reports, 8(1), 4104. https://doi.org/10.1038/s41598-018-22474-8.
Kline, R. B. (2005). Principles and practice of structural equation modeling. New York: Guilford Press.
Krakowski, M. I., & Czobor, P. (2018). Distinctive profiles of traits predisposing to violence in schizophrenia and in the general population. Schizophrenia Research, 202, 267–273.
Lesch, K. P., & Merschdorf, U. (2000). Impulsivity, aggression, and serotonin: A molecular psychobiological perspective. Behavioral Sciences & the Law, 18, 581–604.
Lindstrøm, J. C., Wyller, N. G., Halvorsen, M. M., Hartberg, S., & Lundqvist, C. (2017). Psychometric properties of a Norwegian adaption of the Barratt Impulsiveness Scale-11 in a sample of Parkinson patients, headache patients, and controls. Brain and Behavior, 7(1), e00605. doi:.
Links, P. S., Heslegrave, R., & van Reekum, R. (1999). Impulsivity: Core aspect of borderline personality disorder. Journal of Personality Disorders, 13(1), 1–9.
Malloy-Diniz, L. F., Paula, J. J., Vasconcelos, A. G., Almondes, K. M., Pessoa, R., Faria, L., et al. (2015). Normative data of the Barratt impulsiveness scale 11 (BIS-11) for Brazilian adults. Revista Brasileira de Psiquiatria, 37(3), 245–248.
Mao, T., Pan, W., Zhu, Y., Yang, J., Dong, Q., & Zhou, G. (2018). Self-control mediates the relationship between personality trait and impulsivity. Personality and Individual Differences, 129, 70–75.
Martínez-Loredo, V., Fernández-Hermida, J. R., Fernández-Artamendi, S., Carballo, J. L., & García-Rodríguez, O. (2015). Spanish adaptation and validation of the Barratt Impulsiveness Scale for early adolescents (BIS-11-A). International Journal of Clinical and Health Psychology, 15(3), 274–282.
Menon, V., Sarkar, S., Kattimani, S., & Mathan, K. (2015). Do personality traits such as impulsivity and hostility-aggressiveness predict severity of intent in attempted suicide? Findings from a record based study in south India. Indian Journal of Psychological Medicine, 37(4), 393–398.
Meule, A., Vögele, C., & Kübler, A. (2011). Psychometrische evaluation der deutschen Barratt Impulsiveness Scale - Kurzversion (BIS-15) [Psychometric evaluation of the German Barratt Impulsiveness Scale - short Version (BIS-15)]. Diagnostica, 57, 126–133.
Miller, E., Joseph, S., & Tudway, J. (2004). Assessing the component structure of four self-report measures of impulsivity. Personality and Individual Differences, 37(2), 349–358.
Muthén, L. K., & Muthén, B. O. (1998–2017). Mplus user’s guide (8th ed.). Los Angeles, CA: Muthén & Muthén.
Oquendo, M. A., Baca-García, E., Graver, R., Morales, M., Montalvan, V., & Mann, J. J. (2001). Spanish adaptation of the Barratt impulsiveness scale (BIS-11). European Journal of Psychiatry, 15(3), 147–155.
Orozco-Cabal, L., Rodriguez, M., Herin, D. V., Gempeler, J., & Uribe, M. (2010). Validity and reliability of the abbreviated Barratt impulsiveness scale in Spanish (BIS-15S). Revista Colombiana de Psiquiatria, 39, 93–109.
Paaver, M., Nordquist, N., Parik, J., Harro, M., Oreland, L., & Harro, J. (2007). Platelet MAO activity and the 5-HTT gene promoter polymorphism are associated with impulsivity and cognitive style in visual information processing. Psychopharmacology, 194(4), 545–554.
Paksi, B., Demetrovics, Z., Magi, A., & Felvinczi, K. (2017). [The methodology and sample description of the national survey on addiction problems in Hungary 2015 (NSAPH 2015)]. Neuropsychopharmacologia Hungarica, 19, 55–85.
Paksi, B., Rózsa, S., Kun, B., Arnold, P., & Demetrovics, Z. (2009). A magyar népesség addiktológiai problémái: Az Országos Lakossági Adatfelvétel az Addiktológiai Problémákról (OLAAP) reprezentatív felmérés módszertana és a minta leíró jellemzői. [Addictive behaviors in Hungary: The methodology and sample description of the national survey on addiction problems in Hungary (NSAPH)]. Mentálhigiéné es Pszichoszomatika, 10, 273–300.
Patrick, C. J., Curtin, J. J., & Tellegen, A. (2002). Development and validation of a brief form of the multidimensional personality questionnaire. Psychological Assessment, 14(2), 150–163.
Patton, J. H., Stanford, M. S., & Barratt, E. S. (1995). Factor structure of the Barratt impulsiveness scale. Journal of Clinical Psychology, 51, 768–774.
Potenza, M. N., Kosten, T. R., & Rounsaville, B. J. (2001). Pathological gambling. Journal of the American Medical Association, 386(2), 141–144.
Preuss, U. W., Rujescu, D., Giegling, I., Watzke, S., Koller, G., Zetzsche, T., et al. (2008). Psychometrische Evaluation der deutschsprachigen Version der Barratt-Impulsiveness-Skala. Der Nervenarzt [Nervenarzt], 79(3), 305–319.
Reid, R. C., Cyders, M. A., Moghaddam, J. F., & Fong, T. W. (2014). Psychometric properties of the Barratt Impulsiveness Scale in patients with gambling disorders, hypersexuality, and methamphetamine dependence. Addictive Behaviors ,39(11), 1640–1645.
Reise, S. P., Moore, T. M., Sabb, F. W., Brown, A. K., & London, E. D. (2013). The Barratt impulsiveness scale - 11: Reassessment of its structure in a community sample. Psychological Assessment, 25(2), 631–642.
Rømer Thomsen, K., Callesen, M. B., Hesse, M., Kvamme, T. L., Pedersen, M. M., Pedersen, M. U., et al. (2018). Impulsivity traits and addiction-related behaviors in youth. Journal of Behavioral Addictions, 7(2), 317–330.
Roser, L. P., Hall, L. A., Moser, D. A. (2016). Psychometric properties of the brief symptom inventory hostility subscale in patients with heart failure. Journal of Nursing Measurement, 24(3), 162–175.
Ryan, L. (1997). Integrated support: A case approach to the management of impulsive people. In Webster, C. D., & Jackson, M. A. (Eds.). Impulsivity: Theory, assessment and treatment (pp. 424–433). New York: The Guilford Press.
Sahmelikoglu Onur, O., Tabo, A., Aydin, E., Tuna, O., Maner, A. F., Yildirim, E. A., et al. (2016). Relationship between impulsivity and obsession types in obsessive-compulsive disorder. International Journal of Psychiatry in Clinical Practice, 20(4), 218–223.
Seroczynski, A. D., Bergeman, C. S., & Coccaro, E. F. (1999). Etiology of the impulsivity/aggression relationship: Genes or environment? Psychiatry Research, 86 ,41–57.
Shin, S. H., Lee, S., Jeon, S. M., & Wills, T. A. (2015). Childhood emotional abuse, negative emotion-driven impulsivity, and alcohol use in young adulthood. Child Abuse & Neglect, 50 ,94–103.
Smith, G. T., Fischer, S., Cyders, M. A., Annus, A. M., Spillane, N. S., & McCarthy, D. M. (2007). On the validity and utility of discriminating among impulsivity-like traits. Assessment, 14(2), 155–170.
Someya, T., Sakado, K., Ski, T., Kojima, M., Reist, C., Tang, S. W., et al. (2001). The Japanese version of the Barratt Impulsivity Scale, 11th version (BIS-11): Its reliability and validity. Psychiatry and Clinical Neurosciences, 55, 111–114.
Spinella, M. (2007). Normative data and a short form of the Barratt impulsiveness scale. International Journal of Neuroscience, 117 ,359–368.
Stein, D. J., Hollander, E., & Liebowitz, M. R. (1993). Neurobiology of impulsivity and the impulse control disorders. Journal of Neuropsychiatry and Clinical Neurosciences, 5(1), 9–17.
Steinberg, L., Sharp, C., Stanford, M. S., & Tharp, A. T. (2013). New tricks for an old measure: The development of the Barratt impulsiveness scale-brief (BIS-brief). Psychological Assessment, 25(1), 216–226.
Surís, A. M., Lind, L. M., Kashner, M. T., Bernstein, I. H., Young, K., & Worchel, J. (2005). Aggression and impulsivity instruments: An examination in veterans. Military Psychology, 17(4), 283–297.
Swann, A. C., Bjork, J. M., Moeller, F. G., & Dougherty, D. M. (2002). Two models of impulsivity: Relationship to personality traits and psychopathology. Biological Psychiatry, 51(12), 988–994.
Swann, A. C., Lijffijt, M., Lane, S. D., Steinberg, J. L., & Moeller, F. G. (2009). Trait impulsivity and response inhibition in antisocial personality disorder. Journal of Psychiatric Research, 43(12), 1057–1063.
Tangney, J. P., Baumeister, R. F., & Boone, A. L. (2004). High Self-Control predicts good adjustment, less pathology, better grades, and interpersonal success. Journal of Personality, 72(2), 271–322.
Urbán, R., Kun, B., Farkas, J., Paksi, B., Kökönyei, G., Unoka, Z., et al. (2014). Bifactor structural model of symptom checklists: SCL-90-R and brief symptom inventory (BSI) in a non-clinical community sample. Psychiatry Research, 216, 146–154.
Valdivia-Peralta, M., Fonseca-Pedrero, E., González-Bravo, L., & Lemos-Giráldez, S. (2014). Psychometric properties of the AQ aggression scale in Chilean students. Psicothema, 26(1), 39–46.
Vasconcelos, A. G., Malloy-Diniz, L., & Corrêa, H. (2012). Systematic review of psychometric properties of Barratt impulsiveness scale version 11 (BIS-11). Clinical Neuropsychiatry, 9(2), 61–74.
Verdejo-García, A., Lawrence, A. J., & Clark, L. (2008). Impulsivity as a vulnerability marker for substance-use disorders: Review of findings from high-risk research, problem gamblers and genetic association studies. Neuroscience & Biobehavioral Reviews, 32(4), 777–810.
Von Diemen, L., Szobot, C. M., Kessler, F., & Pechansky, F. (2007). Adaptation and construct validation of the Barratt Impulsiveness Scale (BIS 11) to Brazilian Portuguese for use in adolescents. Revista Brasileira de Psiquiatria, 29(2), 153–156.
Whiteside, S. P., & Lynam, D. R. (2001). The five factor model and impulsivity: Using a structural model of personality to understand impulsivity. Personality and Individual Differences, 30, 669–689.
Winstanley, C. A., Eagle, D. M., & Robbins, T. W. (2006). Behavioral models of impulsivity in relation to ADHD: Translation between clinical and preclinical studies. Clinical Psychology Review, 26(4), 379–395.
Yang, H. Q., Yao, S. Q., & Zhu, X. Z. (2007). The Chinese version of the Barratt impulsiveness scale 11th version (BIS-11) in college students: Its reliability and validity. Chinese Mental Health Journal, 21, 223–225.
Zuckerman, M. (1979). Sensation-seeking: Beyond the optimal level of arousal. Hillsdale, NJ: Erlbaum.
Zuckerman, M., Kuhlman, D. M., Joireman, J., Teta, P., & Kraft, M. (1993). A comparison of three structural models for personality: The big three, the big five, and the alternative five. Journal of Personality and Social Psychology, 65, 757–768.
