Differential impact of trait impulsivity and psychiatrically impulsive behaviors on mental health outcomes
The trait of impulsivity and the overt behaviors used to define this trait are the source of much confusion in psychological and psychiatric literature. The relationship between impulsive behaviors such as alcohol use, drug use, binge eating, violent behavior and suicidal behavior and the trait of impulsivity lacks strong empirical support. Nevertheless, clinical practice and research typically equate the two when determining the need for hospitalization and when evaluating mental health outcomes. The present study assessed the relationship between trait impulsivity and impulsive behaviors and examined the predictive value of both with regard to mental health outcomes. One hundred and one Xerox Corporation employees and their dependents were admitted to intensive levels of care (inpatient, residential, day treatment, intensive outpatient) for psychiatric or substance abuse disorders. Each completed self-report questionnaires assessing impulsivity, emotional health status and symptom severity at baseline, one month, three month and six month follow-ups. In addition, information was collected on rehospitalization during the follow-up period. History of suicidal behavior and of drug use were both strongly associated with two measures of trait impulsivity, while history of alcohol use and binge eating were not related to either measure. Violent behavior was associated with only one of two impulsivity scales. Demographic variables of age, marital status and educational level showed significant associations to behaviors and trait impulsivity. Rehospitalization was the outcome measure most associated with impulsivity, with history of suicidal behavior, gender (female) and one trait scale significantly distinguishing between rehospitalized and non-rehospitalized subjects. Emotional health status and symptom severity were not related to impulsive behaviors, however, higher trait impulsivity scores were associated with poorer emotional health status. These data suggest that impulsive behaviors and trait impulsivity are related, but not a single dimension as prior literature and clinical practice has assumed. Moreover, impulsivity and impulsive behaviors are more associated with treatment than with clinical outcomes.
0347: Mental health