Abstract and Keywords
Impulsivity and affect share important neurobehavioral mechanisms. Impulsivity is a pattern of responses to stimuli without the ability to conform the responses to their context, usually representing either inability to adequately evaluate a stimulus before responding to it or inability to delay the response for a reward. Mechanisms underlying impulsivity overlap substantially with constructs like arousal, attention, motivation, and reward, which are also prominent in regulation of affect. Both impulsivity and affect share relationships with regulation of monoaminergic and amino acid transmitter function. For example, activity of the locus coeruleus is sensitive to unexpected, intense, noxious, or stress-related stimuli. Impulsivity and affective dysregulation are increased by exaggerated or poorly modulated responses in this system. The course of the illness interacts with context-dependent effects on behavior via behavioral sensitization. Repeated exposure to stressors, drugs of abuse, or endogenous norepinephrine release in affective episodes leads to behavioral sensitization with increased impulsivity, affective dysregulation, and substance use. Impulsivity predisposes to, and is increased by, behavioral sensitization. In this context, we discuss impulsivity in depressive, manic, anxious, and mixed states, including suicidal behavior and characteristics of the course of illness that are related to behavioral sensitization.
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