Feb 26
On Impulse: A Comparison Review of Six Knowledge Representation Tools Used In Modeling the Barrett Impulsivity Scale 11 (BIS-11) Instrument


The initial assessment interview and its physical apparatus the psychosocial instrument are the cornerstone of information on which services are provisioned by community-based social service organizations, thus this work will endeavor a comparison review of six various knowledge representation tools. The Barrett Impulsivity Scale 11 (BIS-11) and its parity in the knowledge modeling tools of first-order predicate logic (FOL), topic maps, flow diagram models, inference programming, archetypes, and an ontology structure are critiqued for their viability, complexity and utility under common software implementations.

Table of Contents

1) Introduction

2) Background
    2.1) Knowledge

2.2) Criteria Metrics
3) Evaluation

    4.1) Logic Model

    4.2) Visualization Models

    4.3) Inference Model

    4.4) Semantic Construction Models

5) Conclusion


Advances in technology have rapidly evolved the modern world from an industrial and mechanical age into an age of electronic circuits turning "on" and "off", which in turn begat the information age filled with databases and high-speed networks. Even more recent advances have begun to direct us toward the next step of mankind's destiny, an age of knowledge. This age of knowledge will be driven by knowledge-bases capable of understanding through inferences and interoperable sharing of information on a semantic web. As the evolutionary mechanism of survival of the fittest tests current operations in a variety of disciplines to adopt adaptations in processes and systems that acquire and utilize information, many will be found wanting. One such species of animal that may find the transition difficult is that of the community social service providers. Rigorous expectations of documentation by regulatory agencies, intricate requirements of data transfers by funding and payer organizations and client demands of the highest quality services presented by evidenced-based best practices will facilitate the need for cross-discipline expertise in knowledge tools utilization or hasten extinction. Thus given that the cornerstone of information on which services are provisioned by these social service organizations is the initial assessment interview and its physical apparatus the psychosocial instrument, this work will endeavor an exploratory analysis of the viability, complexity and utility of six various knowledge representation tools. This comparison review will use as its selection the Barrett Impulsivity Scale 11 (BIS-11) and its parity in the knowledge facilities of first-order predicate logic (FOL), topic maps, flow diagram models, inference programming, archetypes, and an ontology structures.



Knowledge can be a very difficult concept to fully comprehend, not so much for its elusive nature, but more so for its pervasive nature. Knowledge comes in a variety of formats, both abstract and concrete. In fact, any understanding a person may have about anything whatsoever is knowledge, thus the difficult aspect of knowledge is representing and communicating that representation to others. It is this task of formalizing the representation of knowledge for the exchange with others, as well as the expansion of our own comprehension of the knowledge we possess that will frame the subject matter presented.

Concept: Psychosocial Assessment

Psychosocial assessments are objective measures of the psychological characteristics that constitute an individual's psychological make-up and/or any conditions of functional impairment. These assessments typically take the form of questionnaire or an interview conducted by trained and licensed professionals. The responses garnered as replies to the questions are transcribed into numerical scores which are used to represent the psychological measure. Development of psychosocial assessments is founded upon principles of psychometric theories.

The discipline of Psychometrics is governed by advanced statistics of factor analysis. Factor analysis has as its constituent investigations, principle components extraction (PC) from either correlation or covariance, principle axis factoring from either correlation or covariance and their respective maximum likelihood, least squares (unweighted or generalized methods), alpha reliability scores, various effects (mixed and non-mixed) models, several possible rotations (orthogonal, oblique, and promax oblique), factor coefficient scores, and optimization statistics (2005). A full endeavor into the calculations of these analyses is beyond the extent of most graduate educations, and as such they are beyond the boundaries of this paper. It might also be added that the underlining psychometrics are beyond the formal education and training of many social service providers' staffs that administer these psychosocial assessments.

Form: The Barrett Impulsivity Scale 11 (BIS-11)

The Barrett Impulsivity Scale is a psycho-social assessment instrument used to measure an individual's level and type of impulsivity. Comprised of 30 questions, each with four possible responses that denotes an escalation within frequencies of occurrences, an individual chooses a response on the basis of their affinity to the scenario presented by each question. The BIS-11 measurement of impulsivity is segmented into three sub-measures of stylistic presence for impulsiveness, with each sub-measure further granulated between two semi-distinct categories of each style.

The higher order factors, which delineate the different dimensional aspects of impulsivity that the BIS-11 captures are Cognitive Attention Styles of Impulsiveness (Ia), Motor Styles of Impulsiveness (Im), and Non-Planning Styles of Impulsiveness (Inp) defined as (Ia) making quick decision, (Im) acting without thinking, and (Inp) a "at the moment now" perspective. Each of these higher order factors has two sub measures of orientation. Cognitive Attention Impulsiveness Style consists of the two factor distinctions of attention, or focusing on the tasks at hand, and cognitive instability, or thought insertions and/or racing thoughts. Motor Impulsiveness Style consists of the two factor distinctions of motor non-cognitive impulsivity, or acting on the spur of the moment, and perseverance, or a focus towards consistency in life. Finally, Non-Planning Impulsiveness Style consists of the two factor distinctions of cognitive complexity defined as enjoyment of task that are mentally challenging, and self-control, otherwise defined as a careful control over planning and thinking. (Patton, Stanford et al. 1995)

The psychometric factor analysis used to determine this structure, as reported by (Patton, Stanford et al. 1995), included an initial analysis for statistical significance of Pearson's product moment item to total correlation. Results from the initial analysis were included in principle component extraction analysis using a PROMAX oblique rotation, on the basis items were not independent since constructed from typical definitions of standard impulsiveness items. A third order variable maximization mixed effects matrix model, likely due to the study sample's between-groupings of 412 college students, 248 psychiatric inpatients, and 78 male prison inmates. Patton, et al. (1995) also verified internal consistency using Cronbach's Alpha as a reliability score. Results have tended to support the validity of the BIS-11 instrument statistical structure (Swann, Bjork et al. 2002) (Caci, Nadalet et al. 2003), and have even correlated with neurological test (Spinella 2007). Some results have also found the need to revise (Swann, Bjork et al. 2002) or refine (Leshem and Glicksohn 2007) considerations of the BIS-11's construct validity. Even so, the BIS-11 instrument is one of the most widely used and accepts instruments in use today (Spinella 2007).

Implementation: BIS-11 in Database Information System

As is likely to be found at any community behavioral social service provider, the initial implementation was constructed within a Microsoft Access developed database for the input and reporting on of data collected using the BIS-11. This implementation holds questions, choices, and client responses in tables of rows and columns. The database will either produce a query of temporary table view that joins identity keys and foreign keys as the data source basis of an input-form and/or static report, or incorporate the identify keys to foreign key match indexes as a schematic relationship structure. Another method that a database developer might use is to construct the form with objects that explicitly reference the location of source data within the database's data storage tables.

Access databases and other desktop applications for data storage, such as Excel Spreadsheets and Word documents, have become prevalent methods of data storage thanks to lowering software cost, increasing feature functionalities, and familiarity thanks to their ubiquitous nature and generational experience. Unfortunately, these applications are of varying benefit as they are relatively brittle methods of data storage that do not facilitate data retrieval, format or content adaption, nor is any such adaptation likely to be backwards compatible. Flaws such as these have understandable caused behavioral treatment providers some skepticism, and in some cases all out protest, concerning technology adoption by providers. (Satsangi, Weir et al. 2003)

Criteria Metrics

Before progressing, it might be prudent to discuss metrics utilized in the critique of the various knowledge representations methods to be explored. While by no means formals nor exhaustive, criteria subject domains attempted to rationalize concerns that might be held by smaller community service providers without access to much capital, technical expertise, and or adaption and implementation time. Some of the concerns include cost considerations and resource requirements in terms of expertise, maintenance and current systems platform interoperability. Effort was also made to highlight salient aspects such providers might find appealing. Such as interface design familiarity, regulation discovery documentation, and enhancement of clinical outcome efficacy, and possible workload reductions by ease of demands and/or use.


Logic Models

The initial basis of any representation that aspires towards the capture and/or encapsulation of knowledge must from the hearth of reason and fires of logic, first be forged. While an exhaustive tutorial on logic and its subtypes is beyond the scope of this paper, a brief introduction is required before embarking upon the application of FOL's encoding methodology.

Form: Logical Notation

Logic is its self a representational system that, at its core, facilitates the formulistic decomposition of arguments into a series of statements depicted as standardized shorthand. A representation in logic could, given this be thought-of as a symbolic substitution used as a method of conveying information that likely contains a complex structure with the use of an again likely simpler tokenization. It is in this manner that one and zero become "on" and "off" information.

The transcribed representation in logical notation can evaluate a proposition's reasoning for selection in terms of its validity, based upon the application of a system of transformative patterns of consistency accepted as logical truth-value theorems. The, if any, violations in the logical patterns of consistency that a representative impersonation selection criteria might incur and, more specifically, which tests they fail thus speak directly to the extent of usefulness the selection definition presents. For example, our binary case can evaluate the validity of the proposition that given one is "on" and zero is "off", if an object's state is "off", then the number should be zero. Digressions into philosophical discussions on "what is truth" aside, it is suffice to say that should the proposition's premise and its conclusion be found to be discordant in their corresponding truthfulness or falsehood, then the representation's usefulness in terms of its validity is called in to question. It could be possible that a more valid representation for "off" is negative one.

Tool: First-Order Predicate Logic (FOL)

First order predicate logic makes further advances from our initial review in logic, referred to as propositional logic, towards a system capable of being more concise in its descriptions with only a slight deviation in its methodology. FOL is concerned with providing a more concise quantification of tautological solution possibilities a preposition's object class provides. Specifically, terms of generality descriptions for such conditions as all (denoted by the symbol) and some (denoted by the symbol Ǝ) are provided. FOL also accommodates expressions of relationships by means of functions that describe an object's properties in terms of other objects and their properties.



Implementation: BIS-11 in First-Order Predicate Logic

This FOL notation states that all impulsivity BIS-11 values (x) is equivalent to the union of all higher order Cognitive Attention impulsivity styles Ia(y) as the union of first order factors, some attention style of impulsiveness Iaa(z) and some cognitive instability Iaci(z) and the union of all higher order Motor impulsivity styles Im(y) as the union of first order factors, some motor-before-cognition impulsiveness style Imm(z) and some motor style of perseverance Imp(z) and the union of all higher order Non-Planning impulsivity styles Inp(y) as the union of first order factors, some cognitive complexity style of impulsiveness Inpcc(z) and some style of self-control Inpsc(z), given each their sets of questions and responses (Q(i),R(j)). A daunting expression in English and Logic Notation, benefits to the adoption of FOL as a means for representing instrumentation knowledge are purely academic. While free to learn, resource requirements in time to learn expertise, implementation, and current system interoperability are monumental. Possible clinical utility to FOL notation adoption is elusive beyond possible seminar discussions and publication efforts. Nor is knowledge readily apparent from FOL notation. Nonetheless, all other methods reviewed will have as their core some variation of reference back to FOL logic.

Visualizations Models

Knowledge need not be a conceptual abstraction. Knowledge is represented in many visual formats that can contain information and could be understood to insinuate more meaning than explicitly presented. Visualization models, while intuitive, can also thread close to over ambition in representation and thus information loss. Visualization models of knowledge can also have drawbacks inherent to display media, heavy computational resource and expertise demands. Although, one should never discount informational aesthetics when building enthusiasm for adoption of knowledge representation systems for it is human nature to reach for the rose in disregards to thorns. Two common and useful candidates for selection as visual knowledge models are Maps and Charts. Our comparison review of knowledge representations will focus on one type of each, the topic map and flow diagram chart.

Form: Topic Map

One type of visual model is the topic map. Topic maps are also known as mind and concept maps, although formally both of these have slight differences. The intent of Map models is the depiction of concepts and their relationship to other concepts. Typically, topic maps show a knowledge concept as a node that often takes the form of geometric symbol, such as a circle or square, with one or more lines that branch out to connect to other concept nodes within the map. It is this spatial orientation between concepts that gives this format the resemblance to geographical maps and thus its name. It should be noted that that some implementations exploit spatial orientation to convey different types of relationships and should not be assumed to denote an expectation of a type of relationship without explicit statement as to its design.

Topic maps are a mature knowledge representation technique. It would not be uncommon or unexpected for users to have some exposure to these maps. They are fairly intuitive and some even consider them fun to create. This type of information map has been used for decades in a variety of disciple domains and just about for any different purposes. Uses for topic maps, beyond simply representing knowledge, include organizational structuring, brainstorming, and analyses of tasks and decisions.

Tool: Cayra Software

Cayra, by Cayra.Net, is a software application that makes use of the topic map visualization format. Compared among the various types of software applications that make use of topic maps, Cayra has a dramatic visual presentation and some well conceived features, as well as the standard features found in topic map software packages. Some of these include: affiliating concept nodes into "clouds" groups; associating parameters and hyperlinks with nodes; bookmarking locations within a map for fast reference; export to html and formats used by other topic map software packages; and an incorporated search by Cayra's built in object types (clouds, links, parameters, and bookmarks). Cayra is still under development and although it is mostly stable, Cayra does suffer some issues of slowdown to responses when maps grow in size. Nonetheless the software is freely available and holds promise.

Implementation: BIS-11 in Cayra Topic Map

Figure 3: Map of Impulsivity Scale & Subscale Factors     Figure 4: One concept Path from factor to response

One benefit of relative significance is that Cayra maps are visual appealing given their colorful presentations of informational content. The software is also easy to use and construction of the topic map within Cayra was not a difficult process. The ability to assign parameters to concept nodes enabled a quick port from the initial implementation within the Microsoft Access Database and into the Cayra software. Not implemented, but of great possible use is that a parameter datatype can be a hyperlink. This feature could be exploited as a method of communication between Cayra topic maps and the a database for such operations as the update or insertion of data into the database. Such a feature would allow a community social service provider to make use of there existing datastorage infastructure, thus reducing implementation costs, overall time to launch the new system and the processes that support it.

Cayra is not without its drawbacks. As alluded to, knowledge visualization models and especially maps, suffer from attempting to convey a three dimentional hiearchial structure of information within a two dimentional medium. This drawback causes information to hidden behind other layers of stratification. Cayra is also resource intensive in terms of hardware utilization. Cayra's dynamic node movement of objects as one traverses the conceptual network topography can both be a thing of enjoyment and fluster. It is hoped that development overcomes these minor flaws. As is Cayra is at only appropriate to serve a niche operation or application, and not as a full-fledge knowledge information system.



Form: Flow Diagram Charts

Another widely used format for knowledge visualization is the flow diagram chart. Similar to topics maps in its use of nodes and lines that show concepts and their relations, flow diagrams incorporate aspects of sequential linearity. The addition of this feature allows flow diagram charts to be used for displaying the course of processes as well as a concept's structure. Some examples of this type of visualization include software modeling, data and work flow processes and procedures.

Tool: Microsoft Visio 2003

Microsoft's premier modeling and diagram product is Visio. Visio's modeling capabilities stretch beyond simple flow chart diagrams and nearly any modeling task is possible. The prevalent and ubiquitous nature of Visio's use by knowledge professionals and the influence of Microsoft on business industries, are ample justification for its selection. Visio's graphical interface also has the standardized Microsoft menu and toolbar layout that is common within Microsoft Office products.

Implementation: BIS-11 in Visio 2003

The main knowledge representation technique explored in utilizing Visio is a methodology defined by the name of Unified Modeling Language (UML). UML allows for the segmentation of operational procedures into an intuitive breakdown into stages of activities, the objects/agents involved, and the specific action necessitated given the place in a sequence of events. Visio also comes with many templates for numerous modeling actives and symbols, or stencils were also readily found on-line and many were free. Visio was able to exchange data between the initially implemented Access database in both importing and exporting directions.

Possibly Visio's greatest strength were also its greatest weaknesses. While interface was familiar Microsoft, the interactions for operations expected by the application was not intuitive. The sheer number of options available for setting properties and invoking events would no dubitably be overwhelming to non-technical users. Data exchange between the database and Visio also required restructuring of the data-tables. The cost might prove prohibitive to some at a suggested MSRP of $559.95(2008). Without Visio expertise it is unlikely Visio could as a knowledge system for service providers, but excelled in conveying information as a visual knowledge model representation.

Inference Models

The encapsulation of knowledge through representation is more than an interesting exercise to gain an alternative perspective on one's information. Knowledge constructed under the basis of sound reason can allow for prediction by means of the heuristics that underlie a model. Traditionally such systems have taken the form of expert system applications. Expert systems are systems of logic, as software that accrue and aggregate knowledge of experts into rules of reasoning and problem solving.

Form: Rules and Rules Programming

The declarative and assertive format of logic models lends itself to formal structures of guidance. If one has a condition for which it is known that a second condition is implied by first, then given the first condition it can be deduced that it thus follows that the second condition will be true. Inference logic is an entire dialect of the logic language that concerns itself with methods of verifying tautologies from only the indirect assertions of propositions statements and assumptions. It should come as no surprise that software development heavily depends on this type of logic. A function that knows it has received the appropriate input parameters can follow its declarative program statement to derive an expected format.

Tool: CLIPS Programming Environment

CLIPS is an inference rules engine written in the C++ programming language that was developed at NASA's Lyndon B. Johnson Space Center by NASA's Software Technology Branch in the mid to late 80's. CLIPS is made available to the public for free. CLIPS has also been under continuous open-source development since its release. Now currently on version 6.3, CLIPS is widely used to construct and model logic rules. (2007)

Implementation: BIS-11 in CLIPS

The BIS-11 in CLIPS allowed for programming of components such as classes of objects and their properties as slots. CLIPS proved extremely complicated and while ample for its intended propose, development implementations would prove prohibitive. The expertise and time for implementation would too not serve in favor of its selection. Although for its capabilities, it does provide what more costly software applications do, but not without its price.



Semantic Construction Models

The knowledge representation techniques reviewed to this point have allowed for the application of a uniform and standardized perspective on information, each with added benefits in terms of functionalities. While these methods have sought to facilitate the identification and dissemination of knowledge, they have all had as their target an implicit boundary of knowledge within an organization. Yet, one of the greatest expected benefits of moving from information systems that are data driven to information systems that are driven to represent knowledge is the capability to discover acquire and assimilate knowledge beyond any singular organization's efforts. Through the exchange of data annotated with terms that reference an asserted and shared semantic meaning, knowledge can cross boundaries dictated by proprietary ownership or storage without compromise or replacements of either. Semantic models hold great promise for improving quality and efficiencies in the domain of healthcare, especially pertaining to the sharing of information in the form of electronic health records. Two methodologies for knowledge representation as semantic models of domain information that share the same outcome goal of proving an asserted meaning to used terms, but which vary slightly in the means they implore in the construction of term definitions are Archetypes and Ontologies.

Form: Archetypes

One method of semantic knowledge representation is the Archetype defined model. Archetype models represent knowledge as universal constructs that encompass the broadest range of applicable meaning for the concept. These generalized forms are then specialized to more succinct semantic structures through constrained incorporation of applicable meanings possible within the boarder context of the term. Further specialization occurs as Archetypical terms intersect with one another, both in the construction and specialization of Archetypical terms, and with the constraints on those intersections.

Tool: openEHR

OpenEHR is a subset of the boarder Electronic Health Record movement for encompassing healthcare information in a interoperable manner between various organizations and across an individual's lifelong occurrences of healthcare events. Ocean Informatics' Archetype Editor Software package is part of Ocean Informatics' suite of OpenEHR applications for implementing and utilizing Archetypes. The Archetype Editor allows for the creation and specialization of Archetypes, as well as construction of form templates that can collect input data. The Editor, along with Ocean Informatics' ADL Workbench can then publish a HTML version of the Archetype's specification model for reference by an organization. Although both the Archetype Editor and ADL Workbench are provided free with open use by the public by Ocean Informatics, the company does not offer their entire Archetype software suite in the same manner. One application in particular, the Archetype Designer greatly enhances Archetype's usefulness. Unlike the Archetype Editor and ADL Workbench, the Archetype Designer allows the composition of Archetypes based upon the incorporation of other Archetypes. As previously described, the intersection of Archetypes is a major portion of refining an Archetype to more succinct semantics structures and thus more useful definitions of meanings.

Implementation: BIS-11 in Ocean Informatics Archetype Editor

Only some development using Archetype Editor was able to be conducted due to limited capabilities in the software offering. Also no available pricing information for implementation of Ocean Informatics full suite of applications was available. This could be an indication of possible high initial start-up or completion costs either in money or worse yet time. While the conceptual methodology of Archetypes is promising, full assessment will have to wait for another time. Still, in terms of regulatory requirements and the expansion of research capabilities with Electronic Health Record knowledge access, Archetypes is definitely a technology for community service providers to follow.

Form: Ontology

All of the knowledge representation techniques reviewed could be considered a type of ontology. Indeed, knowledge representation itself is an ontological exercise, in that an ontology is a theoretical conjecture of what knowledge is, what structure knowledge possesses, and the impact the relationship between knowledge's definition and structure has on understanding knowledge's meaning.

Tool: Protégé 3.4

Developed at Stanford in late 1980's, Protégé has become the de facto Ontology Development Editor, thanks in part to open source distribution and the continual effort on the part of Stanford in furthering Protégé's development to include new discoveries and ever more powerful advancements in Knowledge Representation. Protégé's design and open source nature is accommodating to the efforts of individuals in development of module add-ins that extend and augment the functionality that Protégé is capable offering, including enhancing Protégé's ability to interact with other software applications and environments. To elaborate on this further, add-ins to the Protégé environment have been developed that embed the CLIPS program and also add-ins that provide visualization facilities that can represent the knowledge held within a Protégé ontology as topic maps and/or flow diagrams, along with other visual formats.

Implementation: BIS-11 in Protégé 3.4 as OWL Ontology

Protégé provided unparallel facilities for knowledge representation construction and communication. The well developed software package allowed for defining classes, object properties and data properties of objects and classes. Many available plug-ins provided methods for import and manipulation of data between the initial database and with various applications. The value to a service provider in adoption of Protégé as a means to facilitate the transformation of data information systems into systems of knowledge representation is well worth any initial investment into familiarizing oneself with the principles of ontological development and knowledge information systems. For example with the effort placed to learn an understanding of class structuring as presented by the first of the two graphics below and instances, as presented by the second diagram, a service provider could organize current data collected assessments into structured repositories. One outcome of this example is the third diagram to follow, also known as a tree-map produced by the Protégé add-in Jambalaya, it facilitates the quick and intuitive understanding of how the BIS-11's logical structure as was encoded in our original logic model. Another even more exciting one is the OWL Doc Ontology that Protégé can produce as an HTML webpage of interlinking concepts, their properties, and their relationships for quick and easy reference, which could even be further expanded to reference the location of data or incite an action within a data store. Perhaps, the only negative aspect to found with Protégé is not necessarily specific to the application itself, but rather knowledge representations exercises in general, that being the pervasive nature of knowledge and its elusive description. Protégé, as of yet, has not solved the question of where and how to start knowledge engineering.

Figure 8: Example of Class Structure in Protege


Figure 9: Example of class and instance relationship



Figure 11: OWL Doc Produced by Protege

Discussion and Conclusion

Knowledge representation is an effort well worth the consideration of community social service providers to help further progression of regulatory compliance and quality of services. Technology burned and thus resentful service providers will at best be hesitant and at worst out-right reluctant to adopt knowledge based technologies. Undoubtedly, such an effort will seem a needlessly over-complication of tasks seemingly just as well done with pen and paper. And while it may be that the subject can seem hard to grasp, especially when considering the goal is to have a more concise understanding of one's collected information, but it need not be so. When comprehended knowledge representation can facilitate the simplification of knowledge structure and possibly decrease workloads while increasing service outcome quality. Theoretically, a knowledge structure that does not violate the instrumentation's underlying logic model could allow for discrete partitioning of the instrument's item elements across more than one sitting, thus – again theoretically and assuming no internal consistency reliability violations- turning a single 30 item instrument, into 30 single item micro-instruments. Such explorations will have to be saved for future investigations.

Figure 12: Future Research - Micro-Assessments






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Caci, H., L. Nadalet, et al. (2003). "Functional and dysfunctional impulsivity: contribution to the construct validity." Acta Psychiatrica Scandinavica 107: 34-40.


Leshem, R. and J. Glicksohn (2007). "The construct of impulsivity revisited." Personality and Individual Differences 43(4): 681-691.

    We examine the construct of impulsivity using an organismic-developmental approach. Trait impulsivity was assessed by means of both the Impulsiveness Questionnaire (I7 or I5) and the Barratt Impulsiveness Scale (BIS-11 or BIS-11-A). Cognitive impulsivity was assessed by means of a computerized Matching Familiar Figures Test, the Porteus Maze Test, the Trail Making Test, a computerized Wisconsin Card Sorting Task, and Circle Tracing. Our data were collected from a total of 182 individuals, ranging in age between 14 and 22 years, divided into two groups. Participants were tested individually, and completed the tests in one session lasting approximately 1.5 h. We were able to substantiate our prediction that the multi-faceted construct of impulsivity becomes more differentiated with age: factor analysis revealed two impulsivity factors in the younger age group (primarily ages 14 and 16), and three impulsivity factors in the older group (primarily ages 20 and 22).


Patton, J. H., M. S. Stanford, et al. (1995). "Factor structure of the Barratt Impulsiveness Scale

Factor structure of the Barratt Impulsiveness Scale." Journal of Clinical Psychology 51(6): 768-774.

    The purpose of the present study was to revise the Barratt Impulsiveness Scale Version 10 (BIS-10), identify the factor structure of the items among normals, and compare their scores on the revised form (BIS-11) with psychiatric inpatients and prison inmates. The scale was administered to 412 college undergraduates, 248 psychiatric inpatients, and 73 male prison inmates. Exploratory principal components analysis of the items identified six primary factors and three second-order factors. The three second-order factors were labeled Attentional Impulsiveness, Motor Impulsiveness, and Nonplanning Impulsiveness. Two of the three second-order factors identiffed in the BIS-11 were consistent with those proposed: by Barratt (1985), but no cognitive impulsiveness component was identified per se. The results of the present study suggest that the total score of the BIS-11 is an internally consistent measure of impulsiveness and has potential clinical utility for measuring impulsiveness among selected patient and inmate populations. ABSTRACT FROM AUTHOR Copyright of Journal of Clinical Psychology is the property of John Wiley & Sons Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts)

The purpose of the present study was to revise the Barratt Impulsiveness Scale Version 10 (BIS-10), identify the factor structure of the items among normals, and compare their scores on the revised form (BIS-11) with psychiatric inpatients and prison inmates. The scale was administered to 412 college undergraduates, 248 psychiatric inpatients, and 73 male prison inmates. Exploratory principal components analysis of the items identified six primary factors and three second-order factors. The three second-order factors were labeled Attentional Impulsiveness, Motor Impulsiveness, and Nonplanning Impulsiveness. Two of the three second-order factors identiffed in the BIS-11 were consistent with those proposed: by Barratt (1985), but no cognitive impulsiveness component was identified per se. The results of the present study suggest that the total score of the BIS-11 is an internally consistent measure of impulsiveness and has potential clinical utility for measuring impulsiveness among selected patient and inmate populations. ABSTRACT FROM AUTHOR Copyright of Journal of Clinical Psychology is the property of John Wiley & Sons Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts)


Satsangi, S., C. R. Weir, et al. (2003). "Cognitive evaluation of the predictors of use of computerized protocols by clinicians." AMIA Annu Symp Proc: 574-8.

    We describe a cognitive approach to evaluating the factors that motivate clinicians to use computerized protocols. Using Value-Expectancy theories we developed an open-ended interview to assess clinicians' beliefs and experiences about the use of computerized protocols. Using a qualitative methodology, 3 reviewers independently identified key concepts raised by 13 interviewees. These concepts were aggregated and independently sorted into 39 categories. Then final categories were chosen by consensus. Analysis of the concepts showed consistency across clinician specialties of physicians, nurses and respiratory therapists. Inter-rater reliability calculated using Cohen's Kappa was 0.474. Identified constructs from Value-Expectancy and Intrinsic Motivation theories were: Work Importance, Perception of Situation, Role Relevance, Beliefs regarding Control, Beliefs regarding Normative Expectations, Beliefs regarding Self-Efficacy, Attitude, Habit, Environmental Support and Pre-Behavior. This model will form the basis for an instrument to assess the beliefs and expectations of clinical use regarding the use of computerized protocols.


Spinella, M. (2007). "NORMATIVE DATA AND A SHORT FORM OF THE BARRATT IMPULSIVENESS SCALE." International Journal of Neuroscience 117(3): 359 - 368.

    The Barratt Impulsiveness Scale is one of the most commonly used scales to measure impulsivity. It has demonstrated validity in several neuropsychiatric populations and correlates with objective neuropsychological measures and impulsivity-related behaviors in healthy individuals. Neuroimaging studies show that BIS scores relate to prefrontal structure and function, as well as central serotonergic function. This study reports normative data and demographic influences in a community sample (<i>n</i> = 700). A 15-item short form of the BIS (BIS 15) is presented that retains the 3-factor structure (nonplanning, motor impulsivity, and attention impulsivity), and maintained good reliability and validity.


Swann, A. C., J. M. Bjork, et al. (2002). "Two models of impulsivity: relationship to personality traits and psychopathology." Biological Psychiatry 51(12): 988-994.

    Background: Impulsivity is prominent in psychiatric disorders. Two dominant models of impulsivity are the reward-discounting model, where impulsivity is defined as inability to wait for a larger reward, and the rapid-response model, where impulsivity is defined as responding without adequate assessment of context. We have compared the role of these models of impulsivity in human psychopathology, based on the hypothesis that rapid-response impulsivity would be more strongly related to other aspects of psychopathology and to impulsivity as described by questionnaires. Methods: We investigated relationships between personality and laboratory measures of impulsivity, and between these measures and clinical characteristics, in parents of adolescent subjects with disruptive behavioral disorders (DBDs) and matched control subjects. Diagnoses were rendered using the Structured Interview for DSM-IV. The Barratt Impulsiveness Scale (BIS) was used as a trait measure of impulsivity. Rapid-response impulsivity was assessed using a form of the Continuous Performance Test, the Immediate Memory-Delayed Memory Task (IMT/DMT). Reward-delay impulsivity was measured using two tasks where subjects could choose between smaller immediate or larger delayed rewards. Results: Rapid-response, but not reward-delay impulsivity, was significantly higher in subjects with lifetime Axis I or Axis II diagnoses. Scores on the BIS were elevated in subjects with Axis I diagnoses and correlated significantly with both rapid-response and reward-delay tests, but more strongly with the former. Multiple regression showed that rapid-response, but not reward-delay performance or intelligence quotient, contributed significantly to BIS scores. Correlations were similar in parents of control subjects and of DBD subjects. Conclusions: These data suggest that measures of rapid-response impulsivity and of reward-delay impulsivity are both related to impulsivity as a personality characteristic. The relationship appears stronger, however, for rapid-response impulsivity, as measured by the IMT/DMT. Laboratory and personality measures of impulsivity appear to be related to risk of psychopathology.





Jan 30
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