Barratt Impulsiveness Scale Review

Personality and Individual Differences 47 (2009) 385–395Contents lists available at ScienceDirect Personality and Individual Differences journal homepage: www.elsevier.com/locate/paid Review Fifty years of the Barratt Impulsiveness Scale: An update and review Matthew S. Stanford a,*, Charles W. Mathias b, Donald M. Dougherty b, Sarah L. Lake a, Nathaniel E. Anderson a, Jim H. Patton a a b Baylor University, Department of Psychology and Neuroscience, One Bear Place #97334, Waco, TX 76798-7334, United States University of Texas Health Science Center at San Antonio, Department of Psychiatry, San Antonio, TX 78229-3900, United States a r t i c l e i n f o a b s t r a c t The Barratt Impulsiveness Scale (BIS-11) is a 30 item self-report instrument designed to assess the personality/behavioral construct of impulsiveness. Originally developed as part of a larger attempt to relate anxiety and impulsiveness to psychomotor efficiency, the BIS is arguably the most commonly administered self-report measure for the assessment of impulsiveness in both research and clinical settings. Over the last 50 years the BIS has significantly influenced the way that impulsivity is conceptualized in psychology and psychiatry. On its golden anniversary we thought it important to update the literature in relation to this influential psychometric instrument. The goal of this paper is threefold: (1) describe the history and development of the BIS-11; (2) present new data supporting the psychometric properties of the subscales; and to (3) review the clinical and personality literature that has reported on the BIS-11 subscales. Ó 2009 Elsevier Ltd. All rights reserved. Article history: Received 12 January 2009 Received in revised form 25 March 2009 Accepted 6 April 2009 Available online 1 May 2009 Keywords: Impulsiveness Impulse control BIS-11 1. Introduction Impulsiveness is a construct relevant to explaining both normal individual differences in personality and more extreme personality pathology among clinical populations. Impulsiveness has long been viewed as a complex construct (Barratt & Patton, 1983), which is reflected in one of the more popular definitions of impulsiveness ‘‘as a predisposition toward rapid, unplanned reactions to internal or external stimuli without regard to the negative consequences of these reactions to the impulsive individuals or to others” (Moeller, Barratt, Dougherty, Schmitz, & Swann, 2001). The question of whether a person is capable of modulating their cognition and behavior to fit the demands of a given environment is imperative in almost any conceivable situation. Because of this there is wide spread interest in understanding the role of impulsiveness among healthy populations in activities ranging from employment behaviors (Everton, Mastrangelo, & Jolton, 2005) to educational performance (Diamantopoulou, Rydell, Thorell, & Bohlin, 2007). Generally though, impulsive behavior is viewed as counterproductive by society, and individual differences in impulsivity have been found to be related to a number of socially deviant behaviors like aggression (Houston, Stanford, Villemarette-Pittman, Conklin, & Helfritz, 2003) and substance abuse (Swann, Dougherty, Pazzaglia, Pham, & Moeller, 2004). Finally, impulsivity is a symptom of several disorders including attention-deficit/ * Corresponding author. Tel.: +1 (254) 710 2236; fax: +1 (254) 710 3033. E-mail address: [email protected] (M.S. Stanford). 0191-8869/$ - see front matter Ó 2009 Elsevier Ltd. All rights reserved. doi:10.1016/j.paid.2009.04.008 hyperactivity disorder, borderline personality disorder, and antisocial personality disorder (American Psychiatric Association, 2000), as well as the basis for a separate section in the DSM-IV-TR entitled Impulsive Control Disorders not Elsewhere Classified (which includes intermittent explosive disorder, kleptomania, pyromania, and pathological gambling; American Psychiatric Association, 2000). Given its relevance to both healthy and harmful behaviors, the accurate assessment of impulsiveness has been of wide interest in the scientific literature. 2. Development of the instrument 2.1. History of the Barratt Impulsiveness Scale This year (2009) will mark the 50th anniversary of the Barratt Impulsiveness Scale (BIS; Barratt, 1959). The BIS, currently in its 11th revision (Patton, Stanford, & Barratt, 1995), is a 30 item self-report instrument designed to assess the personality/behavioral construct of impulsiveness (see Appendix). It is arguably the most commonly administered self-report measure specifically designed for the assessment of impulsiveness in both research and clinical settings. As of March 2009 there have been 551 citations of the BIS-11, building on the large number of publications using the preceding versions of the instrument (ISI, 2009). With its widespread application, the BIS has significantly influenced the way that impulsivity is conceptualized in psychology and psychiatry. The goal of this paper is threefold: (1) describe the history and development of the BIS-11; (2) present new data supporting the Ahadi. ignoring both the first. 3.6 [5.2 [7. 2002. 1953) and the Institute for Personality and Ability Testing Anxiety Scale (Cattell.3].. Dougherty. this three subtrait structure of impulsiveness has been consistently demonstrated in the literature (Gerbing. 1983) aimed at developing not only a scale orthogonal to anxiety but also an item pool that more specifically measured impulsiveness in contrast to other ‘‘action-oriented” traits such as sensation seeking. unpublished studies of the BIS-11 were combined. / Personality and Individual Differences 47 (2009) 385–395 psychometric properties of the first and second-order subscales. college students (N = 1178 [m 266. Taylor. Another published study also reported difficulties identifying the Cognitive Impulsiveness subtrait when using the BIS-10 (Luengo et al. The original BIS was developed by Ernest S. had been related to ‘‘habit strength” within the Hull–Spence learning theory (Hull. within the same theory.2. & Mathias. years of education M = 13. or pregnancy test. Participants were recruited via various media outlets and in two settings. Barratt & Patton. Zuckerman Sensation-Seeking Scale (SSS-V. Twain. In the combined sample.0].4 [1. 2004. Carver & White. & Otero. 2005) that included. Subtraits of impulsiveness A review of several factor analytic studies (Barratt. 1993. the third factor had a heavy load of cognitive items and was not exactly the Cognitive Impulsiveness subtrait Barratt had originally conceptualized (Barratt. cognitive complexity. alcohol test.7 [2. motor. Cognitive Impulsiveness involved making quick decisions. Pearson. The PCA produced six first-order factors. Participants were given extra credit in a course for completion of the online battery which took approximately 2 h. along with anxiety. 1985). as measured by the MAS.and second-order subscales. Joseph. Eysenck. As a result. 1991). and Non-Planning Impulsiveness (Barratt. perseverance. Because impulsiveness is such a complex construct. Eysenck.. a subset of the participants also completed a battery of laboratory behavioral measures of impulsivity (Dougherty. & Jagar.5]. Easting.D. Zuckerman. Mathias. Parker. f 272]. 1957) convinced Barratt that impulsiveness was not uni-dimensional. 1985). with one important difference. 1957) were not significantly correlated with the BIS (Barratt. defined as momentary fluctuations in an organism’s propensity to respond to a stimulus. In the first study. 1985). & Eysenck. Eysenck & Eysenck. and Non-Planning Impulsiveness involved a lack of ‘‘futuring” or forethought (Barratt.S.2]. NC. range 6–23) were recruited between 2001 and 2007 from the community to participate in a study of self-reported impulsivity and behavioral assessment. Marsh. Spence. Motor Impulsiveness involved acting without thinking. Recognizing that impulsiveness and anxiety subscales from a number of self-report inventories such as the Thurstone Temperament Schedule (Thurstone. An oblique rotation of the first-order factors showed the expected three secondorder factors. In addition. age M = 21. f 1184].1]. 1967). & Allsopp. This was done to create a larger and more diverse sample with the goal of obtaining psychometric data reflective of the general population. 1977. 1995). the BIS (version 10) was redesigned to measure the theoretical subtraits of Cognitive Impulsiveness.0 [1. 1978) and the Behavioral Inhibition/ Activation Scales (BIS/BAS. 2. 1965.2 [1. 1943. range 17–45. 1959. One month after completion of the initial battery participants were asked to complete the BIS-11 online a second time so that test–retest reliability could be determined. Patton et al. Marsh. While many researchers agree with Barratt’s conclusion that impulsivity is a multi-faceted construct. as he had originally conceptualized. one urban (Houston. (1995) stated that ‘‘the [BIS-11] subfactors are of primary value in helping define impulsiveness in general and exploring more subtle relationships between impulsiveness and different clinical syndromes. self-control. all participants completed the BIS-11 while subsets of the participants completed other self-report measures of impulsivity and risk-taking that included the Eysenck Impulsiveness Questionnaire (I7. this third factor was labeled Attentional Impulsiveness (first-order factors attention and cognitive instability) and defined as an inability to focus attention or concentrate. Ph. 1991.. Principal components analysis (PCA) was conducted on BIS-10 data gathered from a sample of 412 university students. Barratt. Subsequently. a . 1953) and the Guilford–Zimmerman Temperament Survey (Guilford & Zimmerman. n = 248). 1985). TX. and cognitive instability. This hypothesis was supported by early studies that showed the Taylor Manifest Anxiety Scale (MAS. What we have attempted to do in this paper is to summarize in one document the findings from the existing literature on the BIS-11 subscale scores as well as add new psychometric data. 1965. extraversion. in his attempt to relate impulsiveness. To be included in the study. to psychomotor efficiency (Barratt. few studies have attempted to look at the reliability and validity of these scores. 1972. In the second study. After a long series of analyses (Barratt. age M = 19. Luengo. & Tudway. correlations with each other. Motor Impulsiveness. 1987). understanding the relative contribution of each of the subscales is critical for accurately characterizing an individual’s general level of impulsiveness. & Webster. healthy adults (N = 399 [m 127. 1959). Barratt proposed that impulsiveness was composed of three subtraits. range 17–25. Miller. age M = 28. 1965. 1994). the majority of studies using the BIS-11 have reported only the total score. and to (3) review the clinical and personality literature that has reported on the BIS-11 subscales. The BIS-11 came about as Barratt’s final attempt to more specifically define the subtraits of impulsiveness. While subtraits of Motor Impulsiveness (first-order factors motor and perseverance) and Non-planning Impulsiveness (first-order factors self-control and cognitive complexity) were clearly identified. Thus. range 18–45. years of education M = 13. Further. participants could not have any DSM-IV-TR Axis I psychiatric disorder or a positive drug urine test. n = 151) and one rural (Winston-Salem.” While interest in the second-order subscales has steadily increased since the publication of the BIS11. 1956) then impulsiveness might be related to the construct of ‘‘oscillation”. attention. 1987. but also to eliminate items that correlated with measures of anxiety. even though there is continued interest as demonstrated by the number of requests for information by other researchers to the present authors.3]. Barratt theorized that since anxiety. To obtain the present sample of adults (N = 1577 [m 393. Bagby. Carrillo-de-la-Pena. To remedy this we present new psychometric data on the subscale scores in this section. The hypothesized orthogonal nature of impulsiveness and anxiety strongly influenced Barratt’s early work on the BIS such that many of the initial item analyses (both published and unpublished) were done not only to arrive at internal consistency within the BIS. New BIS-11 psychometric data Patton et al. range 6–23) data from two separate ongoing. & Patton. f 912]. Within this three component conceptualization. and risk taking. Barratt hypothesized that these two constructs were orthogonal. usually had non-significant. range 12–15) were asked to complete an online battery of self-report measures of impulsivity. 1949). Stanford et al. This was consistent with previous work that had shown impulsiveness to have a broad first-order factor structure (Gerbing et al. A second and equally significant influence on the development of the BIS was Barratt’s view that impulsiveness was not a uni-dimensional construct.386 M. no study has published psychometric data on the first-order subscales. years of education M = 13. D’haene. 4. Buzby.0 12.1 11. Reynolds. Clinical populations While the BIS-11 has been used in a diverse set of clinical samples. Also. the instrument’s sensitivity to distinctions within substance use disorder is impressive.1) (2.67 0.1.6 (4. Table 1 presents descriptive statistics for the BIS-11 arranged by gender. 2007) and Ecstasy users (Bond. Mathias.4 15.. Axis I disorders other than substance abuse/dependence specifically: Depression. Verheyden.9) 22. the number of daily cigarettes smoked correlates with the Non-planning subscale (Dom. 1983.1) 21.97). and a delay-of-gratification type procedure (Single Key Impulsivity Paradigm [SKIP]). In this section we will briefly review BIS-11 results from studies in these four clinical populations that have reported meaningful differences in the BIS11 subscale scores.7)** (1.72 0. Swann.4) 23. (1995). & Sabbe..9) performance. Intercorrelations between the BIS-11 total score and subscales are presented in Table 3.01. the predominance of studies have tended to focus on Substance Use Disorders. higher BIS-11 scores are found for cocaine dependent adults (Lane.5 6.5.. & Marsh. to designate high impulsiveness.54 odds ratio. / Personality and Individual Differences 47 (2009) 385–395 387 continuous performance test (Immediate and Delayed Memory Tasks [IMT/DMT]).M. Individuals with this level of impulsiveness show more aggression. 2008. ** Note: Adult sample (N = 1577. Hulstijn.6) 16. f 120).3) (2. and Attentional Impulsiveness related to both manic and depressive episodes (Swann et al. (1995).86) and more than twice as likely to have been involved in self-mutilation (2.2) 16.0) 10. This is a common finding since self-report measures like the BIS-11 assess personality traits occurring over extended periods of time and reflect an individual’s subjective experience.73 0. A significant gender difference was found for the first-order subscale perseverance (F(1. Table 5 presents descriptive statistics for the BIS-11 total score and second-order subscales in a variety of adult clinical samples.1 (10.3) 16. A common question asked concerning the BIS-11 is what score can be used to designate an individual as highly impulsive? Several previous studies have used a BIS-11 total score of 74. a stop task (GoStop Impulsivity Paradigm). faster cognitive tempo (Lawrence & Stanford. 95% CI 1. .6 (5. 2005.33–4. Lijffijt.74 0. delay-discounting measure (Two Choice Impulsivity Paradigm [TCIP]). 2003).8) (1.2.1. 4. Consistent with Patton et al. bipolar disordered patients tend to show higher levels of impulsiveness (Peluso et al.8) (2. 2004. Hulstijn. Consistent with previous research. 2008. analysis of variance showed no significant gender differences for either the total score or the second-order subscales.72 0.6) (1.50 0.1. 2003).8 (4.3) (2.72 0. m 393.72 0. Correlations between the BIS-11 and other behavioral and self-report measures of impulsivity are shown in Table 4.. Wingrove.4 (2. 95% CI 1.4) (3. all correlation coefficients statistically significant at p < 0. Bornovalova. Other Axis I disorders A number of studies have shown that the presence of a mood disorder is correlated with a significantly high level of impulsiveness (Peluso et al. Lane. Table 2 presents measures of internal consistency (Cronbach’s a) and test–retest reliability at one month for the BIS-11.2 12. Bipolar Disorder.4 (2. m 393.4 15. 2004) relative to controls. f 1184).9 6. Aubin.27 0. 2006).0 (4..74 0.4 11. Consistent with these findings Peluso and colleagues (2007) have hypothesized that Non-planning Impulsiveness is a state-dependent symptom of unipolar depression. Steinberg.8) (3. 4. van den Eynde et al.8 (3. Scale Total score Second-order subscales Attentional Motor Non-planning First-order subscales Attention Motor Self-control Cognitive complexity Perseverance Cognitive instability No. Pietras.8 (9. Skinner.0 12. The studies reported here were obtained using the ISI Web of Science citation search. Substance use disorders Substance users are known to be highly impulsive and this is reflected in their BIS-11 scores. BIS-11 total scores between 52 and 71 should be thought of as within normal limits for impulsiveness. & Berlin. Rhoades. Scale Total score Second-order subscales Attentional Motor Non-planning First-order subscales Attention Motor Self-control Cognitive complexity Perseverance Cognitive instability Male M (SD) 62. & Curran.83 0. the three subtraits of impulsiveness are differentially related to the affective states of the disorder with Motor Impulsiveness related to the manic episodes. & Curtin. This result suggests that the scale has good concurrent validity.67 0.3 15. 2003).9) 10.01).6 (4.7 (4.25–3.3 (2. differs significantly from males. BIS-11 scores are predictive of the level of an individual’s crack/cocaine use (Lejuez.23 Note: Cronbach’s a calculated using adult sample (N = 1577. Finally.S. 2008). 2006c. Stanford et al.61 0. & Kosten. of items 30 8 11 11 5 7 6 5 4 3 Cronbach’s a 0.2 6. Swann et al. p < 0.59 0. p < 0.35 0.4) (1.64 0. f 1184).2) (3. 2007). 2006a). & Sabbe. Steinberg.0) 23. In comparison to patients with unipolar depression. Mathias & Stanford.3 (10. 1575) = 12. Review of the literature utilizing the BIS-11 subscales 4. 1999) and physiological differences suggestive of low baseline arousal (Houston & Stanford.6 6..1) 23. Non-planning Impulsiveness related to the depressive episodes.9) (3. 2007.01. For instance. as well as suicide attempters and criminal offenders.4 (3..6) (1. 2008). test– retest reliability at one month calculated using N = 153 (m 33.8 6.7 (4. Moeller.9) (3. van den Eynde et al. In bipolar disorder.. which are generally thought to be less severe cases (Dom. 2006) or who has not honestly completed the questionnaire (Helfritz et al. In the college sample reported here individuals scoring 72 or higher were more than twice as likely to have shoplifted an item over $10 (2. & Moeller. Daughters.1) 22.8) (1. Table 2 Internal consistency and test–retest reliability at one month for the BIS-11.23 odds ratio.9) Total M (SD) 62. the BIS-11 is highly correlated with similar self-report measures (convergent validity) but not significantly correlated with behavioral measures of impulsiveness (Barratt & Patton. among alcohol-dependent subjects. 2004).0 11.8) Female M (SD) 62. one standard deviation above the mean reported in Patton et al.1. Swann et al. Review of the present data suggests that a total score of 72 or above should be used to classify an individual as highly impulsive.5) 10. Scores lower than 52 usually are representative of an individual that is either extremely over-controlled (Knyazev & Slobodskaya.3 7.55 Spearman’s Rho 0. & Tcheremissine. 2007. Early-onset alcoholics score higher on the BIS-11 than late-onset alcoholics. Cherek. and Attention-Deficit/Hyperactivity Disorder (AD/HD). While it is not completely surprising that substance abusers would score higher on the BIS-11.83 0. while behavioral procedures assess more state-dependent aspects of impulsivity (Dougherty.48 0. 2008). a greater variability of Table 1 Descriptive statistics for the BIS-11 by gender. 05 0.10** 0.08 0.13 0.27 0.08 0.21** 0.07 TOT 0.01 except.04 n = 336 n = 712 c n = 442 d n = 315 ** p < 0.11 0. Leite.47 0.78 – 0.16** 0.04 sc 0. 2004) or Attentional subscales (Quednow et al.33** 0.21** À0.34** Eysenck Impulsiveness Scale (I7)b Impulsiveness 0.35 0.23** 0.2. violent offenders score higher on the BIS-11 than those convicted of non-violent offenses (Smith.07 GoStop 150 ms ratio 0.05 0.02 0.37 0.07 0.26 0.14** 0.05 À0. 212.05 Scales (BIS/BAS)c 0.76 M.17** À0. Among female prisoners.12 À0. 4. Stanford et al.06 0.16** À0.21 0.02 À0.05 0.47 – Note: Adult sample N = 1577 (m 393. ATT Second-order subscales Attentional Motor Non-planning First-order subscales Attention Motor Self-control Cognitive complexity Perseverance Cognitive instability Total score – 0.08 À0.31** 0.27** 0. those who met criteria for Antisocial Personality Disorder (ASPD) demonstrated significantly higher scores on all BIS-11 subscales compared to those who met criteria for psychopathy or control subjects (Warren & South.37** 0.12** 0.17** 0. Table 4 Correlations of BIS-11 with other self-report and behavioral measures of impulsiveness.05 À0.27** À0.19** 0. & Hardy-Bayle.50 0.30 0.06 0.31 0. healthy adults only [227 Winston-Salem sample.22** 0.388 Table 3 Intercorrelations among BIS-11 subscales.85 – 0.04 À0. 2005).04 0.3.61 – 0. 2001).22 0.08 À0.24** 0. the BIS-11 has been utilized a great deal in criminal populations.19 0.08 0. This finding has been extended to male prisoners as well (Dolan & Fullam.00 À0.30** 0. Sarfati.15 À0.14 ci 0.21** 0.10 per 0.13** À0. college students only).45 0. Among psychiatric patients with a recent suicide at- tempt.30** 0.26** 0.11 0.10** À0.07 0.09 0.06 0.16** À0.31** 0.19** À0.47 0.22** Behavioral Inhibition/Activation Inhibition Reward responsiveness Drive Fun-seeking MOT 0. deficits must exist in the underlying mechanisms of all the subtraits of impulsiveness (Motor. 2006) than those without attempts.29** 0.01 À0.41 0.30 À0..1.01 À0.23** 0.03 0.60 0. for instance.26** 0.09 0.27 0.10 0. f 354.22** 0.10 Behavioral Measures of Impulsivenessd IMT ratio 0.03 0. and Attentional) in this population.14 0.34 0.11** 0.06 À0. 336 college students.69 – 0.39 0. a All correlation coefficients statistically significant at p < 0.53** 0.16 0. 376 healthy adults [233 Winston-Salem sample.39** 0.19** Disinhibition 0.09 0. & Bechara.25** Boredom susceptibility 0.06 cc -0.06 DMT ratio 0. 143 Houston sample]).78 – 0.07 0.05 0.06 À0. 106 healthy adults [Houston sample only]).49 – 0.30** 0.07 0.02 À0.11** Empathy 0. 4.02 À0.19** 0. 2006).14 0.S.36 0.40** 0.42 0.03 À0.76 – 0.06 Experience seeking 0.90 0.06 0.01.07 0. b a (m (m (m (m 88.15** À0. f 500.11 0.27** 0. Forensic populations Impulsivity and aggression are associated constructs and as a result.01 À0.00 TCIP-% short À0. RodriguezJimenez et al. f 1184).09 0.03 0.91 0.01 mot 0. 2006).10 0.44** Venturesomeness 0.08 0. The BIS-11 is sensitive to differences in levels of aggression.17** À0. In this study pathological gamblers with a history of AD/HD had significantly higher BIS-11 total scores and less capacity to delay gratification on a stop signal task than pathological gamblers without a history of AD/HD or controls.16** 0.07 0.12 0.59** 0.18** 0.05 À0. Correa. Adults with a past history of suicide attempt(s) tend to score higher on the BIS-11 Motor (Dougherty et al. 88.14** À0.01 att 0.07 À0.79 0. (2006) found similar results in pathological gamblers with a childhood history of AD/HD using the Spanish version of the BIS-11 (Oquendo et al..15** ** À0.41 0. adults diagnosed with AD/ HD also show significantly higher levels of impulsivity when compared to healthy controls.13 0.07 0. f 248. / Personality and Individual Differences 47 (2009) 385–395 MOT NP att mot sc cc per ci TOT – 0.06 0.01 NP 0.53 0.17** 0.36 0. 2004).02 À0.36** 0. f 189.02 À0. Waterman.32** 0.09 0.16** 0.09 0.29** 0. Suicide attempters Impulsiveness is often a problem for individuals who exhibit suicidal behaviors.28** À0.27 0. Normal populations There have been over 60 published studies that have reported the BIS-11 subscales in normal populations. 2007) in discussing these results theorized that due to the uniformly higher subtrait scores among adults diagnosed with AD/HD.02a 0.03 0.02 0.13** À0.1.20** 0.08 À0.57** 0.31** 0.12 0.11 0.06 À0.07 0.06 0.11 0. Topics have ranged .88 0. 4.51 0.02 SKIP response interval 0.23** 0.39 0.4.33** 0. 126. all BIS-11 subscale scores were higher than orthopedic patients.08 0. Non-planning. and these differences were stable from hospitalization to 1week after discharge (Jallade.25 0.38 0.39** 0. Fuentes.63** 0. Similar to mood disordered patients.05 À0.03 0.06 0.13** 0.50** 0.76 0. Malloy-Diniz and colleagues (Malloy-Diniz.05 0.. 336 college students. 88 Houston sample]). ATT Zuckerman Sensation-Seeking Scale (SSS-V)a Thrill-adventure seeking 0. & Ward.30** 0. 2 (7.0) 13.0 36.5) 28.3) 23.3) (3.8) 77.5) (5.5) (13.8) 57.4 (3. (2007) 96/34 5/12 4/14 5/13 11/39 0/32 0/15 14/5 11/13 8/32 11/13 0/5 11/0 22/28 10/20 0/39 0/16 0/15 15/9 18/6 7/3 8/4 25/7 Bjork.4 (5.5 (2.4 (12.7 33.9 (8.2) (10.8) 30.4 28.7 23.1 (3.6)* 25.86) (4.1) (10.1 (7.5) (5.7) 28.6) 23.3 (1. (2005) 20 13 8 20 10 20 26 35.9) (5.3 71.4 (18.9 24.0) 11.9 (3.1 17.7 (6.6) Dom et al. / Personality and Individual Differences 47 (2009) 385–395 Table 5 BIS-11 descriptive statistics for published adult clinical samples.3 (3.2) 23.4 0/40 5/13 0/18 16.4) 18. Hommer.2 25.5) 79. (2007) Peluso et al.0)* (3.6 (4.4 (7.0) 24.8) (5. (2007) van den Eynde et al. abuse With sub.3) (5.8 (5.6) (4.2) (5.9 17.1) (6.6 39.6 23.8 28.6 17.68) (12. (2004) Bond et al.7 25.5 (5.2) (6.9 (14.4 (5.6 69.0 27.8) (4.0 18.5) 26.1) (6.8 ? 68.0 (5.3) 26. Sample Substance use disorders Substance abusers Substance users Current users Former users Mixed Sub. Bradshaw.7) 72.7) 20.3 (4.1 37.1 82.6 (9. & Danube (2004) Moeller et al.7 59.4) 24.1 (9.5 (3.3) 20.1) (5.7 (4.6 (14.5) 18.6) (8.5) 16.3 25.2 27.0 (6.1) (4.0) 25.4 27.5 80.9 17.8) 18.3 22. (2005) Enticott.6) 22.3) 22.6 13.7) (3.1) (14.6 (11.0) (3.6 21.0 14.3 74.6 (6.1 34.0) Swann et al.6)* 27.8) 27. & Paulus (2007) Leland & Paulus.8) 79. (2007) Muller et al.6) (2.3 34.7 (13.0 (6.5 30.9) 15.0 (3.8 38.4 70.6) 20.7 (4.9 31.8) 25.8) 77.1 (3.2 29.9 41.4) (13.5) 17.1) 24.2) 73.0 16.9 47.5 (3.2 46.5) NP M (SD) 24.9) (6.6 68.3) 64.2 28.9) Cherek & Lane (2000) Nasser.9) 77.4 (6. Nicholls. (2007) Moeller.1) TOT M (SD) ? 59.7) 27. Dougherty et al.4 (4.1 (5.9) 19.4) 74. (2006a) 60.0) 21.0) 28. Gluck.2 21. & Fitzgerald (2008) 18 18 42.9 (7.7) Source Swann et al.7 22.9 66.9) (3.2) (6.3 18.1) 29.4) 30.9 (5.8) 20.3 (4.1) 84.5) (5. (2006) 45. Grant.9 (3.5 (3.7) (13.M.8 (13.5) 73.1) 19.6) 29.8) 28.6) 20.0 36. (2004) 389 0/18 56/0 0/96 Conklin & Stanford (2008) Lejuez et al.5 (4. (2004) 68.5 (11.7) (4.8) 23.S.7 71.0) 27.6) Swann et al.6 (7.8 (5.7) Dom et al.7 (15.0) (10. & Geliebter (2004) Malloy-Diniz et al.9 (11.9 (7.3) 22.3)* 18.9 (15.1 45.7 (5.5 29.2) 25.3) 22.1) 27.3) 82.2 (6.2) (7.4 (6.2) 27.3) 17. Leland. (2008) Swann et al.4) 31.9 (8.1 (5. (2006c) 14/48 26/42 61.2) 23.5) (3.4) 6.4 (4.7 (7.7) (3.9 (17.3 (11.8 (3.3 (6.2 (12.8 (4.7) 77.2) (3. Ersche.0) (6.2 32.5 19.6 (4.0 38.0) 27.4 27.7 (4.1 (13.3 (4.8) 14.8) 21.7) (4.9 (5.7 26.1 27.3 (7.5) (4.4 88.5) 27.2 70.9 (6.5) (4.6) 31.0 22 12 74 24 17 16 17 20/19 20.1) (3. (2007) Rodriguez-Jimenez et al.8) 28.5) (13.7) 23. 2005 Clark.8 (5.9 (4.9 (3.5) 30.3 33.4) 45.7 (11.5) (4.4 (3. Stanford et al.3 (4.7 30.2) 28.1 14.8) 13.9 (5.1) 27.0 (15.1 (4.8) (7.2 39.0 (5. Dougherty.9 77.2) 26.8) (8.2 (5.3) (11.1 (6. (2007) Dolan & Fullam (2004) (continued on next page) .6 24.2) (5.9 23.5 38.4 19.9 (4.8) (4.8 (5.9 65. & Sahakian (2006) 18.2) 18.4) 21.6 (7.4 (3.2 (5.1 (15.2 42.2) 76.0 29.7 27.7 17.0 (6.2 (15.5) 18.5)* 14.2 28.9 17.9 (8.1 (3.9 37.1 (9.2) 26.1) 19.2 21.1 (8.5 28.8 28. abuse Bipolar disorder Euthymic Manic Bipolar disorder + SUD Interepisode Depressed Manic Mixed Suicide attempters Bipolar + suicide attempts No attempts Not severe attempt Medically severe Suicide attempters Single Multiple Attempt + depression Single suicide attempt Forensic populations Violent offenders with schizophrenia BPD prisoners Offender + Axis I High impulsivity Low impulsivity n 35 32 32 18 56 96 62 68 42 46 130 17 18 18 50 32 15 19 24 40 24 5 11 50 30 39 16 15 24 24 10 12 32 15 12 33.5 (6.0) 23.6) Dougherty et al.3 31.7) MOT M (SD) 25.7) 6.5) 75.6 65.0) 18.8 M Age F/M ATT M (SD) 17.5) 81.9)* 18.7) 31.7 (4.1 (3.6) (3.2) (1.2 26.9) 23.6) 67.6) (4.8 (5.7) 24.8 (4.3) (20.0) ? ? Westheide et al.0 21. (2001) Bond et al.3) 29.9 41.2) 26.7) 24.0 33. Ogloff. Robbins.4 (5.1) 70.3) 25.8) 19.3 (6.8) (5.3) 27.0 19.9) 26.2 27.6 (5.2) 31.7 (5.8 (1.4 (3.0) 17.4 25. dependence Substance dependent Females Males Alcoholic Early onset Late onset Alcoholic Early onset Late onset Alcohol dependent Cocaine dependent Cocaine dependent Cocaine dependent Cocaine dependent MDMA (Ecstasy) users Stimulant dependent Stimulant users Substance users Amphetamine User Opiate user Exdrug users Other Axis I disorders Conduct disorder Obese binge eaters AD/HD AD/HD Pathological gamblers –AD/HD +AD/HD Depression Depression Unipolar Bipolar Euthymic Unipolar Bipolar Bipolar disorder Bipolar disorder Without sub.5) (4.5 30.8 (11.0 31.6) (13.4 (5.3 (5.6 13.5)* (6.1 39.1 (14. Churan.5 (4.4 25.8 (4.2 20 20 36.2) 27.0)* 15.6 15/9 11/5 5/3 14/6 7/3 8/12 17/9 19. (2004) Moeller et al.5 (3.4) Kirkpatrick et al.6) (6.4) 26.7 (5.5) 52.8) 26.7) (1.2) 62.5 45.4) (.9) 24.9 (3. (2004) Wittmann. (2005) Lane et al.6 (5.4 (5.4 37.8 (7.7) 74.9 (5.8) (4.6) 65.4 (3.5 (5.2) (5.1 18.8 26.2 (15.8) (4.5 (0.3) (5.1 (18.3) 27.7) 29.8 37.2) (5.0 35.2)* 15.9) 17. & Moeller (2003) Quednow et al. (2004) Swann.2) (12. (2008) 74.6) 60.5 (5.7) (14.5 (4.4 20. Pazzaglia.1 34.0 35.6 26.8 28.2 27.6 (3. (2006) Jallade et al.6 (5.2 26.7 (5.9) 26.9 (2.0 (11.6) (3.4 (7. 7 (5. (2007) 55.6 25.8) 17.6 22.2 (3.5 63.1 22.1 (5.1 (6.3) 18. gambling 42 65.1 16.6) (4.2) (5.3 (5.4) 75.6) 15.8 25.2)* Neurodegenerative disorders and traumatic brain injury Traumatic brain injury Non-aggressive 18 38.2 (5.3) 22. so it is assumed that this is equivalent to the Attentional Impulsiveness score.0 42.3) 16.8 (4.3 (6.6) 28.5) (6.7) 23.1 (7.0 (5. & Maffei (2007) 50 25 14 474 170 55. For instance. BIS-11 scores do seem to be related to problems with attention.5) 71.8 23.4) 23.8 (4. Ubbiali.0 (12.2) 28.4) 26.2 (5.0) (7.3) 18.2 6/15 Axis I/II mixed samples Recommended therapy Group Individual None Veteran Med/Psych Physically aggressive 15.7 (4.9) 64.9) 24.6) 27.6) TOT M (SD) 74.1) 21. attention on a task-switching paradigm was reduced among the high BIS-11 group following a tryptophan-enriched breakfast.8) 23. George.8 (5. (2005) Kockler & Stanford (2008) * Indicates this value was reported as the Cognitive score. 2004) found increased P2a event related potential activity for the high group performing a stimulus match/mismatch paradigm in which non-predicted rewards were occasionally delivered.2 (12.6) 27.8 (4.8 (4.2) 52.9) 28.0) (15.3 (4. & Barratt.0 (3.1) Greve et al. While one study (Markus & Jonkman.6 (4.5) (4.0) (5.1 (4.8) 23.8)* 21.8 19. 4.4 62. (2006) Brown et al.6) (17.2) 23.5) 18. Chiorri.9 (3.8) (4. problems with the attention system may result in impulsive behavior.6 (9.5) (6.7) (4.1 (22.5 (7.5 (12.8) 19.2 (7.2.7 20.1 32. Donati.7) 16.6 (4.6) 21.1) 22. Noblett.0 38.2 (8.7 M.6 37.0 23.0 (11.8 (6. (2007) 54. Punishment and reinforcement sensitivity Impulsivity has long been considered from the perspective of reduced punishment sensitivity or response inhibition.2) Voon et al.3) ? ? Swann.6 (2.8 (8. In this section we will review articles in three areas of significant importance to the measurement of impulsiveness.7) 17.9 27.0) 27.0) Dom. Stanford et al.3 22. Moeller. 4. 2002). Bjork.8)* 18.0) Source Smith et al.9) 17.2.1) 24. & Bowman.6 (8.0) (5.6) 19.3 (4.4) (7.9 2/16 Traumatic brain injury Non-aggressive 19 38.6) (4.7) 23.9 28.9) ? ? ? 63. (2002) Dougherty. Martin.0)* MOT M (SD) 27.3)* (4.1) 61.9 (8.5 (15.5 (5.5 (6.0) 25.0) 64.1) 16. Moeller.7 21/21 +Path.2) 68. The finding of both low behavioral inhibition and high behavioral activation in high impulsive individuals is consistent with Gray’s theory (Gray.8 26.4)* (5.4 (13.7 (3.4) 20.9) 21.0) 60.390 Table 5 (continued) Sample Offenders Violent male Nonviolent male Violent female Nonviolent female DUI conviction Female offenders ASPD PCL-R >25 ASPD + PCL-R>25 Axis II disorders Hospitalized BPD Personality disorder –Axis I +Axis I Lifetime psychiatry DX Axis I Axis II Alcohol dependent No PD +BPD +ASPD Alcohol dependent No PD Cluster B n 57 58 66 67 104 23 21 44 14 45 59 12 22 178 29 40 40 22 41.2 (16.8) (3. De Wilde.1 (5. Hulstijn.4 (4. In studies using the BIS-11 with psychophysiological measures.1 (10. Another study (Levine.1 (14.0) NP M (SD) 28.4) Rubio et al.5 24.0) 25. & Dougherty (2002) 66.4 37.8 (11.9) (16. Huckabee.2.7 21. & Sabbe (2006b) 49.2 (4.0 (6.7) 21.8 44.0 15.8) (6.1.0 43/431 42/128 23. Waite.S.1) 65.8) 72.9 (5.6) 25. the BIS-11 is significantly correlated with measures of cognitive failure.6) 24.1 20.9 (3.0 ? (18. 1987). This effect was interpreted as reflecting a greater susceptibility of high impulsive individuals to changes in arousal produced by the tryptophan enhancement.8) 63.8 62.7 22.4 (3.3 (5.9 2/24 Parkinson disease –Path.1 (5.2 (5. Bjork. (2005) Warren & South (2006) 20. from investigating the general nature of impulsivity to developmental issues and employment screening.3)* (4.7 (17.4 (5. 2005) found evidence of reduced behavioral inhibition among those with higher BIS-11 scores.1 (4.9 (5. BIS-11 scores were significantly correlated with scores on a measure of academic distractibility.1) 20.2 (4. This study classified adults as low or high in impulsivity and measured sensitivity to punishment using the error-related negativity (ErN).2 (4.2) (6.8) 24.0) 16.1) (4.2) 20. but referenced Patton et al.7 (8.0 (5.8 (11.8 (5.3) 26. Executive function and decision making Problems with the control of information processing or executive functioning can lead to impulsive behaviors and individuals who have executive function deficits tend to score higher on the BIS-11.3 (12. (2001) 44. / Personality and Individual Differences 47 (2009) 385–395 F/M 0/57 0/58 66/0 67/0 0/104 23/0 21/0 44/0 14/0 11/36 13/50 ATT M (SD) 18.2) 19.2 (4.8 (7. One study (Potts.4 25.2.6 24.2 (7.4) 14.1 (4.0) (5. & Coccaro (2005) 0/178 0/29 0/40 19.2 (5.6) ? Suris et al.1) 16.2 M Age 27.9) Greve et al. 2007) tested impulsivity as it relates to lapses in attention or distractibility.3) 20.8) (5.1 42.3)* 14.8 (16. (1995) as the source.3 31.9 1/17 Impulsive aggression 18 35.2) 14.5 16.9 26.1 23.2 (13. which are also correlated with .8 (5.0) 24.9 2/17 Impulsive aggression 26 33.9 (6.1 17.5 (7. 2007) failed to find any differences in attention between those scoring high and low on the BIS-11 at baseline.6)* (4.2 24.9) 24.1 (14.6 24. Another study of college students using the BIS-11 reported evidence of increased sensitivity to reward for the high impulsive group. gambling 21 60.0)* 21.0) 19.05) 72.3 16. Van Brink.9 (8. This study (Martin & Potts.4 (4.2) Visintini.3) 18. McCloskey. 4.7) (5.3) (6.8 (4. Vigilance and attention While impulsivity is a distinct psychological process from lapses in attention (Sonuga-Barke. & Swann (1999) Bunce.3. impulsivity appears related to Gray’s (1981) behavioral inhibition and activation systems.6 16. 2003). & Halperin. the vast differences in sample size. Translations of the BIS-11 are available in Chinese (Yang. Using several measures of executive control Whitney. age of sample. correlated (negatively) most strongly with the BIS-11 Nonplanning Impulsiveness subscale. it appears that genetic polymorphisms that would result in lower serotonergic activity predict higher impulsiveness. & Zhu.. Oosterlaan. accounted for a significant amount of variance in the Letter–Number Sequencing (WAIS-III) task. & Christodoulou. Further. French (Bayle et al. 2007). German (Preuss et al. Their analysis supported the conclusion that Attentional Impulsiveness was related to participants deleting no-longer-relevant information from working memory while Non-planning Impulsiveness was related to working memory capacity. / Personality and Individual Differences 47 (2009) 385–395 391 anterior cingulate activation (Garavan. and language of the BIS-11 make direct comparison across these studies difficult. Muratake. However. Clark.. Markianos. In another study. Mundt. 2007). & Stein. such as those leading to delinquency. those involved in serotonin function (e. premotor cortex. 1999.. 1994) the authors suggest that the BIS-11a not be considered a reliable or valid measure of impulsiveness and strongly recommend that it not be used. & Canli. executive function was assessed using measures of cognitive flexibility (Wisconsin Card Sort Test [WCST].S. They assert that because they were able to show that some forms of impulsiveness are related to problems with different executive control abilities. striatum. Huang. During the development of the BIS-11. health/clinical characteristics of the sample. The BIS-11a problem The BIS-11 as described in Patton et al. Vaidakis. gene by environment interactions may account for the mixed findings. 5-HT1b. Eisenberg et al. For any definitive statement to be made about genetic correlates of impulsiveness. It has been reported that those with the short allele polymorphism of the serotonin transporter gene promoter region (5-HTTLPR)... Unfortunately.g. some other genetic variations have been explored with regard to BIS-11 scores. In this study (Cheung. Spinella found that these correlations were independent of age. is clearly related to and interacts with the processes of attention and executive function. more research needs to be accomplished with replication and greater consistency in terms of sampling characteristics and environmental variables. which is reflective of activity in the dorsolateral prefrontal cortex.. No significant relationships or group differences have been found for BIS-11 subscale scores and genetic or allelic polymorphisms of dopamine (Congdon. or education and found that the EFI negatively correlated with other measures reflective of impulsive behavior such as poor college GPA (Spinella & Miley. 2007).. Four measures were derived from the continuous memory scanning task and used to predict BIS-11 scores using regression analysis. Müller. the C allele of the T102C serotonin 2a receptor (Bjork et al. 5-HT2a. & Sahakian. & Murphy. 5-HTTLPR. 2008). Moving beyond the serotonin system. negatively correlated most significantly with the BIS-11 Motor Impulsiveness subscale. 2003). 2003). which addresses self-inhibition and is reflective of orbitofrontal activity. after controlling for full-scale IQ. 2003). Although trait impulsivity seems a distinct latent variable.. & de Wit. BIS-11 Motor Impulsiveness accounted for a significant portion of the variance in two measures of executive functioning on the WCST: category fluency and categories achieved. In summary. Additionally. Roche. Jameson. Tolliver. 2002) and T allele at the A-161T locus of the 5-HT1b receptor gene (Zouk et al. Stanford et al. Bengel. Trail Making Task) and intelligence (WAIS-III). 4. Ross. defining executive control ability as a single index may obscure the role of specific functions in controlling specific behaviors. 2004).3. Genetic studies with the BIS-11 A number of studies have tested genetic correlates of impulsiveness using the BIS-11. & van den Brink. Studies have also reported significant relationships between the BIS-11 and other aspects of the serotonin system including single nucleotide polymorphisms of the tryptophan hydroxylase-2 (TPH2) gene (de Lara et al..5. supplementary motor area. Spinella (2005) developed a self-rated index of executive function (Executive Function Index. 2004). and Hinson (2004) demonstrated that different subtypes of impulsivity are related to different aspects of executive control of working memory. BIS-11 total score. EFI) composed of five subscales. 4. while another found no difference among those with low or high activity MAOA alleles (Passamonti et al. 2007). 2007).. 2006). For instance one study with children reported a significant negative relationship between MAO activity and the BIS-11 (Paaver et al. Of these five subscales the Strategic Planning subscale. Sand. In summary. Estonian (Paaver et al. 2008.. Murphy. this ‘‘working” version of the scale has been more widely disseminated than was ever intended or anticipated by Barratt and his colleagues. Lesch. these differences may be greatest for the Attentional subscale of the BIS-11 (Sakado.4. Italian (Fos- . of the various genes tested. sex. 2003). not all studies have found a significant relationship between this polymorphism and BIS-11 (Paaver et al. 2007). 2007. 2002). Lesch et al. Cingulate activation is important in fast-paced tasks where inhibition of more automatic behaviors is important. & Someya. although in a much less systematic manner. Yao. 2007). 2007). which is associated with reduced serotonin turnover (Greenberg. The main problem is that the BIS-11a and BIS-11 only share 24 items in common and thus the scores on these two instruments cannot be accurately compared to one another. for some but not all cases. Further. (1995) is the most up to date and psychometrically sound version of the Barratt Impulsiveness Scale. These variables may therefore contribute to the modulation of state impulsivity in certain situations. TPH2. Other versions of the instrument should not be used unless the goal is to make comparisons with data obtained using an earlier version of the BIS. Sakado. 1994) was distributed to several labs for review. 2000). The Impulse Control subscale. since simple Mendelian genetic influences are rare for complex phenotypes like impulsivity. However. an intermediate version of the scale often designated in the literature as the BIS-11a (Barratt. or the alpha 2a noradrenergic receptor (Sequeira et al. impulsivity in general.M. the BIS-11 has been translated into at least 11 other languages. 2005). Translations While originally developed and normed in English. Attentional Impulsiveness accounted for significant variance in the difference between parts A (simple visual search) and B (cognitive set shifting) on the Trail Making Test. including state impulsivity. De Beurs. Motor Impulsiveness proved to be related to a trend towards having a lower overall capacity and a greater ability to restrict access to working memory.. 1996). the andenosine receptor (Alsene. 4. and MAO) have been the most commonly studied in relation to the BIS-11. Deckert. and visuospatial system. This version resulted from a partial analysis of BIS-10 data during the early development phase of version 11.. Roiser. Mitsis. A majority of these studies have focused on genetic polymorphisms having to do with the function of the serotonin system. Given its limited psychometric development (Barratt. Dutch (Goudriaan. Hebrew (Glicksohn & Nahari. have increased impulsivity scores on the BIS-11 (Baca-Garcia et al. Greek (Giotakos. 7 I plan trips well ahead of time. Its inclusion in all future studies of impulsiveness and consistent reporting of its subscales would help bring about uniformity in definition that has been missing in the impulsivity literature and allow for a level of comparison across studies that would be unparalleled in personality research. Dr. 15 I like to think about complex problems. We have conducted this review of the BIS-11 as a resource to other investigators in order to maintain the momentum generated by Dr. Read each statement and put an X on the appropriate circle on the right side of this page. 5. & Pechansky.” 6 I have ‘‘racing” thoughts.71–0. 21 I change residences. This is a test to measure some of the ways in which you act and think. and education. 2 I do things without thinking. criminal justice. Acquarini. It is our hope that as research on impulsiveness moves forward that the BIS-11 might be viewed as a standard point of reference. For questions pertaining to the instrument please contact the corresponding author. 2001). / Personality and Individual Differences 47 (2009) 385–395 sati. s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s . 22 I buy things on impulse. Cha. Korean (Chung & Lee. Answer quickly and honestly s s s s Rarely/Never Occasionally Often Almost Always/Always 1 I plan tasks carefully. with Dr. Szobot. 2007) and Spanish (Oquendo et al.392 M. Kim. That having been said. the internal consistencies (Cronbach’s a) reported for the BIS-11 total score from these translations all fall within an acceptable range (0. 11 I ‘‘squirm” at plays or lectures. 20 I am a steady thinker. Its impact is felt across a broad range of domains including mental health. 24 I change hobbies. Dr. 30 I am future oriented.. 17 I act ‘‘on impulse. 25 I spend or charge more than I earn. 12 I am a careful thinker. 19 I act on the spur of the moment. Appendix Directions: People differ in the ways they act and think in different situations. In addition. Ernest S. Because the availability of psychometric data related to the reliability and validity of these translations varies greatly. 2008). & Erlen. Portuguese (von Diemen. the field lost a visionary leader. For future research we recommend that back translation (Brislin. Japanese (Someya et al. 29 I like puzzles. Barratt’s significant body of work. There have been great advances during the past 50 years in terms of the assessment of impulsivity. 1970. 2007) be used when conducting research with the BIS-11 in a language other than English. 1997). Kessler. as does the translation techniques used in their development. 14 I say things without thinking. 23 I can only think about one thing at a time. Sadly. 27 I am more interested in the present than the future. caution is suggested when interpreting outcomes from translated instruments or comparing them to the original. 5 I don’t ‘‘pay attention.. as has been done in Bipolar Disorder (Swann et al. 26 I often have extraneous thoughts when thinking. Stanford is active in maintaining the BIS-11 and advising other investigators on its use and interpretation. Barratt and his impulsiveness scale have played a significant role in that progress. 8 I am self controlled. 13 I plan for job security. 2001). 16 I change jobs. Di Ceglie. 4 I am happy-go-lucky. may result in more effective diagnosis and treatment. Few personality traits are as socially relevant as impulsiveness. 9 I concentrate easily. 28 I am restless at the theater or lectures. 3 I make-up my mind quickly.83) suggesting that the scale is reliable across these diverse cultures. Barratt’s unexpected passing in 2005.” 18 I get easily bored when solving thought problems. & Barratt. it is suggested that a more detailed investigation of the BIS-11 subscales within differing psychopathologies.S. Back translation significantly improves the reliability and validity of a scale by requiring that the quality of the translation be verified by an independent translator translating back into the original language. Stanford et al. Do not spend too much time on any statement. 2001). 10 I save regularly. 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