Relations among Behavioral and Questionnaire Measures of Impulsivity in a Sample of Suicide Attempters

Impulsivity is a risk factor for suicidal outcomes (e.g., suicidal ideation, suicide attempts, and death by suicide; for a review, see Brezo, Paris, & Turecki, 2006). However, impulsivity is a heterogeneous construct, believed to reflect divergent processes. Given the multifacted nature of impulsivity, and the multiple approaches used to assess this construct and its subcomponents, it is essential to test the overlap among various methods that are purportedly tapping the same psychological processes. This focus can facilitate more refined scientific communication, aid attempts to develop more precise measures of impulsivity facets, and ultimately improve the theoretical and clinical utility of research linking impulsivity with suicidal behaviors. More specifically, impulsivity is a broad construct that has been assessed using multiple methods (e.g., self-report questionnaires, behavioral tasks) when studying maladaptive outcomes such as suicidal behaviors (e.g., Dougherty et al., 2004; Swann et al., 2005). Although “impulsivity” is a common term, there is no general consensus regarding strict definitions of this construct or its possible components. There are a multitude of definitions of impulsivity (e.g., Moeller, Barratt, Dougherty, Schmitz, & Swann, 2001), which leads to inconsistent use of the term across and within research domains and disciplines. As noted by several researchers (e.g., Cyders & Coskunpinar, 2011; Smith et al., 2007), this indistinctness hampers scientific progress on several fronts, including impeding translational approaches, obscuring theory, and hindering the development of clinical interventions. Given the disagreements in how to best define the construct of impulsivity and its facets, it is unsurprising that researchers have developed a plethora of different assessment methods and approaches. For example, numerous studies have focused their attention on developing self-reported assessments of impulsivity. Consolidating various self-report measures through the use of exploratory and confirmatory factor analysis, Whiteside and Lynam (2001) suggested a four-factor solution for impulsivity: sensation seeking, lack of planning, lack of persistence, and urgency (acting rashly when distressed). However, a separate area of research has focused on the development of behavioral assessments of impulsivity. Numerous behavioral tasks have been developed, including tasks thought to measure inhibitory control (e.g., the Go Stop Task; Dougherty, Mathias, Marsh, & Jagar, 2005), persistence (e.g., the Mirror Tracing Persistence Task; Strong et al., 2003) risk taking (e.g., the Balloon Analogue Risk Task; Lejuez et al., 2002), and delayed discounting (e.g., the Single Key Impulsivity Paradigm; Dougherty, Mathias, Marsh, & Jagar, 2005; see Cyders & Coskupinar, 2011; Strauss & Smith, 2009 for a detailed discussion of construct validity for questionnaire and behavioral assessments). There have been increasing efforts to organize various facets of impulsivity as measured by both questionnaire and behavioral approaches. In order to facilitate increased consilience among research groups that tend to utilize either questionnaire or behavioral measures of impulsivity, some researchers have suggested conceptual overlap among some impulsivity facets assessed by self-report measures (e.g., the UPPS facets) and behavioral indicators of impulsivity. Specifically, as noted by Dick et al. (2010) and Bechara and Van der Linden (2005), urgency may relate to measures of prepotent response inhibition (e.g., go/no go tasks). Indeed, some initial evidence suggested that performance on go/no-go tasks correlated with measures of urgency (Gay, Rochat, Billieux, d’Acremont, & Van der Linden, 2008). However, more recent evidence suggests that consilience may be difficult between questionnaire measures and behavioral tasks thought to assess similar impulsivity facets. In a recent meta-analysis, Cyders and Coskunpinar (2011) found significant but small (significant rs ranged from .10-.13) overlap between laboratory tasks and questionnaire-based measures of impulsivity. Based on these findings, Cyders and Coskunpinar concluded that the various measures of “impulsivity” should not be referred to as measuring the same construct and researchers should carefully specify the constructs they are aiming to operationalize when using both behavioral and questionnaire-based measures of impulsivity. The goal of the current paper is to examine the relations among various questionnaire and behavioral assessments of impulsivity in a sample of recent suicide attempters. Specifically, this multitrait, multimethod approach does not have any bearing on the “impulsivity” of the recent suicide attempt but rather illuminates the extent to which multiple measures (e.g., self-report urgency and behavioral prepotent response measures) thought to assess the same construct (e.g., inhibitory control) overlap in a high-risk sample of interest to both researchers and clinicians (i.e., suicide attempters). This information can be used to improve future research and clinical efforts involving suicidal behaviors by allowing for more informed decisions when assessing traits related to impulsivity. Further, these results can help guide attempts to design measures of impulsivity in specific clinical samples by showing strengths and shortcomings of existing approaches for assessing impulsivity.