1

Measuring impulsivity in daily life: A systematic review and recommendations for future

research

Sarah A. Griffin,1 Lindsey K. Freeman,1 & Timothy J. Trull1

1Department of Psychological Sciences, University of Missouri-Columbia.

Submitted for publication 2-14-2020

This paper is not the copy of record and will not exactly replicate the authoritative document published. Please do not copy or cite without the author’s permission.

Authors’ Note. The National Institute on Alcohol Abuse and Alcoholism at the National

Institutes of Health supported S.A.G. and L.K.F.’s contributions to this work (T32AA013526).

Correspondence concerning this article should be addressed to: Sarah A. Griffin, 150

Psychology, Department of Psychological Sciences, University of Missouri-Columbia,

Columbia, MO 65211. Email: [email protected] IMPULSIVITY IN DAILY LIFE 2

Abstract Impulsivity is a multi-dimensional construct that has shown utility in relation to important occupational, functional, and clinical outcomes (e.g. substance use, social functioning, aggression) in cross-sectional studies. However, trait and cross-sectional assessments of impulsivity have shown less utility in prospectively predicting specific instances of these outcomes. The recent proliferation of mobile technology has allowed for investigation into psychological phenomena in participants’ daily lives, clarifying many momentary and prospective relationships. Studying impulsivity using daily life methods offers promise in understanding impulsive processes and proximal influences on behavior. We conducted a systematic review of the literature to identify studies assessing impulsivity in daily life to characterize the conceptualization, measurement, and validity of momentary impulsivity. The studies reviewed highlight the reliability and validity of the construct of momentary impulsivity and identify areas for improvement in measurement and statistical practices. We make suggestions for future research based on the evidence presented. Key words: impulsivity, ecological momentary assessment, systematic review, psychometrics, ambulatory assessment, disinhibition, sensation seeking Public significance statement: This study reviewed and summarized published empirical studies on state impulsivity. This review found that state impulsivity can be reliably and validly measured and relates to emotional and behavioral outcomes. IMPULSIVITY IN DAILY LIFE 3

The construct of impulsivity has a long history of relevance to the fields of psychiatry and clinical psychology. Almost all models of personality and personality pathology have included a representation of impulsivity, and this construct has shown notable trans-diagnostic relevance across the lifespan. Of note, impulsive behaviors and features appear in the diagnostic criteria of approximately 20 disorders in the latest Diagnostic and Statistical Manual of Mental

Disorders (DSM-5; (American Psychiatric Association, 2013). Prominent examples include

Attention-Deficit Hyperactivity Disorder, Oppositional Defiant Disorder, Borderline and

Antisocial Personality Disorders, and Substance Use Disorders.

Most investigations into impulsivity have occurred at the cross-sectional trait-level, assessing impulsivity as a personality characteristic generally stable across time and situation. To be sure, trait-level impulsivity has shown significant value in predicting important behavior and life outcomes. For example, in both clinical and non-clinical samples, impulsivity has been linked to worse outcomes in educational achievement (e.g., Spinella & Miley, 2003), social functioning (e.g., Bagge et al., 2004), occupational success (e.g., Barrick, Mount, & Judge,

2001), and physical and mental health (e.g., Bogg & Roberts, 2004). Concerning clinical outcomes, higher scores in general impulsivity have predicted drug and alcohol use (e.g.,

Verdejo-García, Lawrence, & Clark, 2008), bingeing and purging behaviors (e.g., Dawe &

Loxton, 2004), engagement in self-injurious behaviors (e.g., Glenn & Klonsky, 2010), and aggression and violence (e.g., Miller, Zeichner, & Wilson, 2012), among other clinically-relevant behaviors.

Although trait-level impulsivity has shown significant utility in predicting general patterns in these outcomes and behaviors, several fundamental issues with trait-level measures of impulsivity exist. We briefly summarize these issues here and refer readers elsewhere for a more IMPULSIVITY IN DAILY LIFE 4 complete discussion (see: Cyders & Coskunpinar, 2011; DeYoung, 2011; Dick et al., 2010).

First, there is no consensus on the definition of impulsivity. A wide variety of terms and operationalizations have been used to describe impulsive tendencies including: disinhibition, inattention, risk taking, venturesomeness, and lack of deliberation, impulse control, or cognitive restraint or control. Moreover, these operationalizations and associated research tends to be siloed within fields.

Second, drawing distinctions between different operationalizations of impulsivity is not simply an intellectual exercise. Impulsivity has been shown to be comprised of many meaningfully distinct constructs (e.g., Evenden, 1999; Whiteside & Lynam, 2001), and it may be better thought of as a domain. Component constructs of the domain of impulsivity have shown discrete and significant relationships with outcomes of interest. For example, traits associated with behavioral disinhibition (e.g., sensation seeking, risk taking) are associated consistently with substance use and engagement in potentially dangerous or aggressive behaviors

(e.g., Berg, Latzman, Bliwise, & Lilienfeld, 2015; Griffin, Lynam, & Samuel, 2018), while the tendency to act on urges under strong negative emotion (i.e., urgency) is linked to self-injurious and suicidal behaviors, and bulimic symptoms across studies (e.g., Hamza, Willoughby, &

Heffer, 2015).

Third, because impulsivity and its components are defined and operationalized in so many ways, assessments of impulsive constructs vary widely and differ from each other dramatically, which may be problematic. For one, it is difficult to draw conclusions across studies because even measures of ostensibly the same constructs frequently differ in important ways and the same instrument is rarely used across studies. Additionally, recent work has shown poor convergence between self-report and behavioral task assessments intended to measure the IMPULSIVITY IN DAILY LIFE 5 same constructs (e.g., Cyders & Coskunpinar, 2011). Collectively these issues impede the comparison and integration of findings across studies.

Perhaps of most importance, although impulsive traits have shown significant utility in predicting general patterns in these outcomes and behaviors, impulsive traits have shown less utility in prospectively predicting specific instances of these outcomes. In other words, impulsive traits generally can identify who will engage in specific maladaptive behaviors, but these traits are less useful in identifying when or under what circumstances those behaviors will occur.

Studies using baseline trait measures of impulsivity to prospectively predict behavior typically reveal only small to moderate effects. In response to this, researchers have shown increasing interest in assessing impulsive constructs in daily life, shifting the focus from trait measures to features that may fluctuate within and across days.

Conceptually, momentary impulsivity is not new. For example, researchers in the field of

Attention-Deficit Hyperactivity Disorder (ADHD) have noted impulsive symptoms of the disorder fluctuate across time, even within days, (e.g., (Spencer, Biederman, & Mick, 2007; van der Meere, 2005). Research on self-control (i.e., the inverse of impulsivity) suggests that self- control seems to deplete and replenish in predictable patterns over time (e.g., (Muraven &

Baumeister, 2000). Common sense and clinical intuition have also incorporated the idea that impulsivity fluctuates—no one expects an “impulsive” person to be rash and disinhibited in every moment of the day. Rather, we inherently acknowledge that impulsivity may be manifested in some moments and not in others. However, the empirical literature has only recently begun to explicitly and empirically measure impulsivity and associated features within specific moments in time. IMPULSIVITY IN DAILY LIFE 6

To date, several studies of daily life have utilized measures of impulsivity at the momentary or day-level. Impulsivity constructs were assessed repeatedly within relatively brief timeframes to allow researchers to study fluctuations over time, representing a notable break from the tradition of assessing impulsivity only as a stable trait construct. This conceptualization of momentary impulsivity has shown some validity in relation to behaviors and outcomes. For example, momentary assessments of impulsivity have shown positive associations with momentary irritability and quarrelsomeness (aan het Rot, Moskowitz, & Young, 2015), general negative affect (Tomko et al., 2015), and substance use (Trull, Wycoff, Lane, Carpenter, &

Brown, 2016).

Despite this preliminary evidence of predictive validity, the aforementioned measurement issues of trait-level assessments of impulsivity are also relevant to assessments of momentary impulsivity. However, to date no reviews of the literature on momentary assessments of impulsivity have been conducted. Given increased interest in studying psychological phenomena in participants’ daily lives (e.g., using ambulatory assessment (AA) methods; Trull & Ebner-

Priemer, 2013), we sought to investigate how researchers have conceptualized, measured, and analyzed impulsivity at the “state” level, compared to its traditional trait-like conceptualizations.

Therefore, we reviewed the published literature that utilized momentary or daily assessments of impulsivity to evaluate the state of the literature as well as issues of measurement associated with these assessments, including: conceptualizations and definitions of impulsivity, assessment methods, and the validity evidence of impulsivity at the momentary or “state” level. Our aim was to both summarize the research on state impulsivity to date as well as to highlight issues related to the conceptualization, measurement, and validity of state impulsivity in daily life.

Method IMPULSIVITY IN DAILY LIFE 7

We conducted a systematic literature search using Google Scholar, PsychInfo, and

Pubmed to identify studies that: 1) administered repeated assessments of impulsivity; 2) repeated assessments occurred in participants’ daily lives1; and 3) analyzed impulsivity data for within- person effects (e.g., did not aggregate scores on repeated measures to single values across the study). First, manual searches for studies citing or related to Tomko and colleagues (2014) were conducted using Google Scholar, given that the paper was the first, to our knowledge, that developed a scale explicitly designed to assess momentary impulsivity within an EMA framework. Then, searches combining terms (“experience sampling” OR “ambulatory assessment” or “ecological momentary assessment” OR EMA) AND (impulsivity OR disinhibition OR “sensation seeking” OR urgency OR premeditation OR perseverance OR non- planning OR inattention) were conducted using PsychInfo, Pubmed, and Google Scholar (see

Figure 1). We identified relevant studies published up until July 2019 and did not review pre- prints that had not already been accepted for publication at a peer-reviewed journal (i.e., we did not consider manuscripts not in press or in print). Initial searches were intentionally broad and over-inclusive, allowing for identification of search terms in the body of the manuscript, to ensure identification of eligible studies for inclusion. This strategy did, however, result in a large number of “false identifications” that were then excluded, the most common being studies mentioning EMA or experience sampling as a future direction.

We reviewed titles and abstracts of studies returned from the searches and included articles that assessed impulsivity at least at the daily level using any form of ambulatory assessment (behavioral task, daily diary, symptom-based assessment, smartphone surveys, etc.).

We focused on articles that directly assessed constructs empirically related to impulsive traits,

1 We did not exclude studies involving constraints in participant environment (e.g., prisons, hospitals), but did exclude studies that only assessed impulsivity in laboratory settings. IMPULSIVITY IN DAILY LIFE 8 adopting a broad definition of impulsivity (i.e. related to behavioral, cognitive, affective, and motivational aspects of impulsivity). Specific behaviors (e.g. substance use, binge eating, gambling) historically have been used as indicators of or proxies for impulsivity; however, given the inability to determine whether a specific behavior was “impulsive” without additional information, we excluded studies that solely reported behaviors without additional information establishing whether that behavior was impulsive. We also excluded studies which only presented between-person analyses using aggregated repeated measures of impulsivity (e.g., using the mean score of a measure across multiple days), even if the measure was assessed at the momentary- or day-level. Finally, studies were also excluded that measured impulsivity as a component of a larger domain scale without providing within-person analysis of impulsivity items alone (e.g., Zimmermann et al., 2019).

In total, data from 25 articles from 19 separate samples are reported in Tables 1, 2, and 3.

Twenty-five percent of the articles were double-coded and overall inter-rater reliability in coding was 84% across all three tables. All discrepancies were resolved by committee. Samples are grouped in each table by how impulsivity was conceptualized: studies that operationalized impulsivity as a component of a general model of personality are listed first, followed by studies that considered impulsivity to be a symptom of ADHD or BPD, respectively. Finally, studies that gave more specific operationalizations of impulsivity (e.g. risk-taking propensity) are listed last.

Table 1 provides an overview of each sample and of the design characteristics used. This table is organized to highlight (1) the nature of the sample (e.g. community participants, outpatients, inpatients), (2) how many participants were included, (3) the percentage of the sample that identified as female, (4) the mean age of the sample, (5) the duration of the EMA study period, (6) the timeframe that prompts referred to (e.g. since the last prompt, in the past 15 IMPULSIVITY IN DAILY LIFE 9 minutes, for the past day), (7) the number of scheduled assessments per day, (8) whether self- initiated prompts were included in the study design, and (9) the percent compliance for scheduled assessments.

Table 2 provides an overview of the measure of impulsivity that was used in each study, including if the authors provided full text of the items used and if the authors reported psychometric properties of the impulsivity measure. Table 2 also describes the level of analysis for each study included (i.e. momentary-, day-, or person-level). Finally, Table 3 summarizes the main findings as they were originally reported from each study, again grouped by how impulsivity was conceptualized, and highlighting the outcomes of interest within each study.

Results are presented by level of analysis.

Description of Studies Reviewed

Personality-Based Assessments of Impulsivity. A total of 15 articles used personality- based conceptualizations or assessments of impulsivity, representing 10 separate samples. These

10 samples contain data from 986 distinct participants, with an average of 99 and a range from

24 (Stamates, Linden-Carmichael, Preonas, & Lau-Barraco, 2019) to 294 (Sperry, Barrantes-

Vidal, & Kwapil, 2018; Sperry, Lynam, & Kwapil, 2018) participants. Most of the participants in these samples were female (median percent female reported=69.2%) and, on average, were approximately 27 years old. The average duration of the EMA period was 21 days with 4 scheduled prompts per day. Four of the ten samples only assessed impulsivity once per day.

Across samples and studies nine different measures were used to assess a total of six distinct personality conceptualizations, four of which represented impulsivity as a multidimensional construct. Three studies reporting on separate samples (aan het Rot et al.,

2015; Ansell, Laws, Roche, & Sinha, 2015; Pihet, De Ridder, & Suter, 2017) employed a IMPULSIVITY IN DAILY LIFE 10 conceptualization based on the Barratt Impulsiveness Scale-11 (BIS-11; Patton, Stanford, &

Barratt, 1995) model of impulsivity, although all three of these used different measures of momentary impulsivity. Five studies (from two distinct samples) used the Momentary

Impulsivity Scale (Tomko et al., 2014), which is based on the BIS-11 model and the impulsivity criterion for Borderline Personality Disorder (BPD) from the Structured Interview for DSM-IV

Personality (Pfohl, Blum, & Zimmerman, 1997). The dimensional model of personality disorder traits was represented by three studies, one of which adapted the Personality Inventory for the

DSM-5 (PID-5; Krueger, Derringer, Markon, Watson, & Skodol, 2012), and two of which used a measure derived from the PID-5 and the Computer Adaptive Test for Personality Disorders

(CAT-PD; Simms et al., 2011). The UPPS-P model of impulsivity (Whiteside & Lynam, 2001) was utilized in two studies (Sperry, Barrantes-Vidal, et al., 2018; Sperry, Lynam, et al., 2018) published from the same sample. The UPPS-P model assesses five aspects of impulsivity: positive and negative urgency (mood-based acting on urges), low perseverance, low premeditation, and sensation seeking. The remaining two studies utilized single items to assess impulsivity in the moment which characterized impulsivity as a state related to mood (Husky et al., 2017) and experiencing impulsive urges (Ammerman, Olino, Coccaro, & McCloskey, 2017).

Of the nine distinct measures used across the 15 papers, only two assessments were developed specifically for use in daily-life studies: the MIS (Tomko et al., 2014) and the assessment of daily personality pathology manifestation used in Wright et al. (2015) and Wright and Simms (2016). These two assessments were used in seven of the 15 personality-based papers, representing three of the ten samples. The remaining seven measures were either original to the paper (e.g., Husky et al., 2017) or were derived from cross-sectional, or trait-based, IMPULSIVITY IN DAILY LIFE 11 assessments that were created and intended to measure stable impulsive traits at a single point in time (e.g., UPPS-P, BIS-11).

Seven of the fifteen personality-based studies reported multi-level reliability of the measure used. Most reported good to excellent reliability at the between-person level and moderate-to-good reliability at the within-person level.

Task-Based Assessments of Impulsivity. Four studies (Jones, Tiplady, Houben,

Nederkoorn, & Field, 2018; MacLean, Pincus, Smyth, Geier, & Wilson, 2018; McCarthy,

Minami, Bold, Yeh, & Chapman, 2018; Treloar Padovano, Janssen, Emery, Carpenter, &

Miranda, 2019) used task-based measures of momentary impulsivity. Two studies (MacLean et al, 2018; Treloar Padovano et al., 2019) adapted a behavioral risk-taking task (Balloon Analogue

Risk Task [BART]; Lejuez et al., 2002) for use on smartphones. McCarthy and colleagues

(2018) used a task adapted from the Continuous Performance Test-II (CPT-II; Conners et al.,

2000) and a monetary choice task modeled after Johnson and Bickel (2002), to assess momentary impulsive action and choice, respectively. Jones and colleagues (2018) adapted a stop-signal task (Verbruggen & Logan, 2008) for use on smartphones to assess behavioral disinhibition, or difficulties inhibiting behavior. Only one of these studies (Jones et al., 2018) reported multilevel psychometric properties of the task used to measure impulsivity

(McDonald’s omega = .96), and only one study (MacLean et al., 2018) directly compared the derived ambulatory task measure to the original laboratory measure before the EMA study began.

Across these four studies using task-based assessments of impulsivity, data were reported from 285 participants, with individual sample sizes ranging from 29 to 105. Across studies, the average participant age was 33.8, and the average percent female in these samples was 52.0%. IMPULSIVITY IN DAILY LIFE 12

The average duration of the EMA data collection period across these studies was 14.8 days

(range 7-31). All four studies prompted participants to respond to surveys and behavioral tasks multiple times per day, and two of these studies (Jones et al., 2018; MacLean et al., 2018) also included event contingent alcohol craving prompts and smoking prompts, respectively.

Symptom-Based Assessments of Impulsivity. Three studies (Hennig, Krkovic, &

Lincoln, 2017; Mitchell et al., 2014; Schmid, Stadler, Dirk, Fiege, & Gawrilow, 2016) conceptualized and measured impulsivity as a symptom of attention deficit hyperactivity disorder (ADHD), two studies (Law, Fleeson, Arnold, & Furr, 2016; Miskewicz et al., 2015) conceptualized and measured impulsivity as a symptom of borderline personality disorder

(BPD), and one (Depp et al., 2016) conceptualized it as relevant to the expression of bipolar disorder (BD).

Among the papers that conceptualized impulsivity as a symptom of ADHD, each used varying numbers of items to measure momentary impulsivity (range 3-11 items). Two of the studies (Mitchell et al., 2014; Schmid et al., 2016) included separate scales for inattention and hyperactivity/impulsivity. Schmid and colleagues (2016) adapted items from an existing symptom-based measure (Döpfner et al., 2008), and Mitchell and colleagues (2014) and Hennig and colleagues adapted items from DSM-IV-TR and DSM-5 criteria, respectively. Two studies

(Hennig et al., 2017; Schmid et al., 2016) reported multilevel reliability estimates (average within-person alpha = .54; average between-person alpha = .65).

The authors that conceptualized impulsivity as a symptom of BPD used comparatively fewer items to assess momentary impulsivity, and created two items corresponding to the DSM-5 impulsivity criterion for BPD. Both papers, from the same sample, also reported within-person psychometric properties of the measure (Rc = .65). Depp and colleagues (2016), who based their IMPULSIVITY IN DAILY LIFE 13 assessment in the manifestation and symptoms of bipolar disorder, used only one item to assess momentary impulsivity and did not report any psychometric properties.

Across these six studies published using symptom-based measures of momentary impulsivity, there was a total of 795 individuals (total N for ADHD studies = 244; total N for

BPD/BD studies = 551), with individual sample sizes ranging from 17 to 255. Across studies, the average participant age was 32.7 (20.3 for ADHD samples and 45.0 for BPD/BD samples), and the average percent female in these samples was 55.2 (47.4 for ADHD samples and 63.1 for

BPD/BD samples). The average duration of the EMA data collection period across these studies was 32.7 days (range 7-77). One study (Schmid et al., 2016) only assessed participants once per day, but the remaining five studies prompted participants multiple times per day to complete questionnaires. Finally, one study (Mitchell et al., 2014) included event-contingent prompts, whereby participants were instructed to complete questions about current ADHD symptoms prior to and after smoking a cigarette.

Summary Findings

Content/Criterion Validity

Content validity. Nine papers (aan het Rot et al., 2015; MacLean et al., 2018; McCarthy et al., 2018; Roche, 2018; Sperry, Lynam, et al., 2018; Tomko et al., 2014, 2015; Treloar

Padovano et al., 2019; Wright & Simms, 2016) examined the relationship between baseline measures of impulsivity and momentary impulsivity measures. These papers all derived their momentary impulsivity measures from existing cross-sectional measures, but only three directly compared person-level aggregates of momentary scores on the derived measures with baseline scores on the original measure (Roche, 2018; Tomko et al., 2014; Tomko et al., 2015). All reported good convergence, reporting significant positive correlations between derived scale IMPULSIVITY IN DAILY LIFE 14 scores and original scale scores. These studies demonstrate that momentary impulsivity scores aggregated over time reasonably relate to baseline impulsivity scores when assessed by directly derived measures, with correlations ranging from .26 to .66.

Four additional papers also sought to assess alignment between the original cross- sectional measure and the momentary one by using these baseline scores on the original measure to predict impulsivity at a given moment (versus person-level aggregated means) on the derived measure. Sperry, Lynam, & Kwapil (2018) found significant associations between their momentary impulsivity index, derived from the UPPS-P, and all subscales of the UPPS. aan het

Rot and colleagues (2015) reported that BIS-11 motor impulsiveness, but not attentional or non- planning impulsiveness, predicted momentary impulsivity. Wright & Simms (2016) reported that baseline PID-5 Disinhibition scores did not predict their daily impulsivity measure, which was partially derived from the PID-5. Similarly, baseline performance on the BART behavioral risk- taking task did not significantly predict performance on the derived momentary task in the field

(Treloar Padovano et al., 2018). These three papers showed poorer ability of baseline cross- sectional assessments to predict impulsivity in a given moment, even when assessed by a directly derived measure.

Criterion validity. Only three studies evaluated the relationship between the momentary impulsivity measure and other impulsivity assessments. Tomko and colleagues (2014, 2015) reported significant correlations between the aggregated MIS scores and the UPPS negative urgency, lack of premeditation, and lack of perseverance subscales (but not the sensation seeking subscale). MacLean et al. (2018) found that lower baseline sensation seeking and higher positive urgency was related to greater average variability in pumps on the mBART. Another study that used a task-based measure of impulsivity did not find a significant relationship between the IMPULSIVITY IN DAILY LIFE 15 momentary task measure and baseline impulsivity assessed by the BIS-11 (McCarthy et al.,

2018).

Momentary Impulsivity as Outcome of Interest

Measure Development. Three studies explicitly reported procedures used to develop a novel momentary impulsivity assessment (Roche, 2018; Tomko et al., 2014; Wright & Simms,

2016). All three reported identifying an initial item pool and then selecting items based on statistical criteria (e.g., inter-item correlations, factor analysis of items) for the final measure.

Within-person reliability of these measures ranged from moderate (RCN = 0.56; Tomko et al.,

2014) to good (α= 0.82 [Urgency]; Wright & Simms, 2016) and between-person reliabilities

ranged from good (α= 0.82 [Impulsivity]; Wright & Simms, 2016) to excellent (RCN = 0.99;

Tomko et al., 2014). The three measures developed in these papers were used in a total of nine studies included in this review, the most frequently used being the Momentary Impulsivity Scale

(MIS; Tomko et al., 2014).

Two additional studies aimed to develop or introduce a novel measure of momentary impulsivity (MacLean et al., 2018; Pihet et al., 2017). Pihet and colleagues (2017) reported excluding one item post-hoc from their three-item scale to improve within-person reliability of the scale sum score. The remaining measurement development study (MacLean et al., 2018) reported making minimal changes in the established BART paradigm (Lejuez et al., 2002) when adapting it for mobile phone administration, only changing the number of trials to reduce participant burden.

Among the remaining 14 studies, the most common method of measure development was selecting or deriving items from existing scales or diagnostic criteria without reporting systematic procedures or statistical criteria for item selection or modification. Only three studies IMPULSIVITY IN DAILY LIFE 16

(Ammerman et al., 2017; Depp et al., 2016; Husky et al., 2017) reported generating their own items with no basis in existing measurement. Coincidentally, all three used single item assessments of momentary impulsivity.

Patterns in momentary impulsivity. Two studies reported that impulsivity fluctuated significantly across days (Schmid et al., 2016; Wright & Simms, 2016). Tomko and colleagues

(2014) reported that participants who endorsed the impulsivity criterion for BPD showed greater daily fluctuations in impulsivity than those who did not. Additionally, Wright and Simms (2016) observed moderate stability in impulsivity across 100 days, reporting correlations of the mean impulsivity scale score between thirds of the data ranging from .70-.85 and correlations of the variability in impulsivity score between thirds of the data ranging from .69-.79. One study reported that participants’ impulsivity increased over the course of the study (i.e., participants took more risks on the mBART on average; MacLean et al., 2018). Overall, these findings suggest that impulsivity does fluctuate over time, especially within relatively short (i.e. daily) timeframes.

Differences in momentary impulsivity between groups. Tomko and colleagues (2014,

2015) reported that people with BPD reported greater momentary MIS scores, and more instability in MIS scores on average compared to people with a depression diagnosis.

Furthermore, Hepp and colleagues (2016) reported that person-level impulsivity scores were negatively correlated with Agreeableness for people with BPD, and negatively correlated with

Conscientiousness for people with depressive disorders (DDs). Higher levels of manic symptoms and higher suicidality was also related to aggregated impulsivity scores (Depp et al., 2016). One study examined gender differences, and found that males exhibited more risk-taking on the mBART on average compared to females (MacLean et al., 2018).

Momentary Impulsivity and Emotion IMPULSIVITY IN DAILY LIFE 17

Six papers incorporated emotion or mood as a variable of interest—three as a predictor of impulsivity (Sperry, Barrantes-Vidal, et al., 2018; Sperry, Lynam, et al., 2018; Tomko et al.,

2015), two as both a predictor and an outcome related to impulsivity (Depp et al., 2016; Law et al., 2016), and one as a moderating variable (Stamates et al., 2019). Impulsivity was used as a predictor of mood in only two studies. Both found that EMA-reported impulsivity did not predict subsequent negative affect (Depp et al., 2016; Law et al., 2016). However, one reported that momentary impulsivity did predict later decreases in positive affect (Depp et al., 2016).

All five studies using affect as a predictor of impulsivity found that various forms negative affect predicted impulsivity. It should be acknowledged that these studies used different assessments of distinct forms of negative affect (e.g., undifferentiated negative affect, irritability). Three studies found that increased negative affect in the moment was associated with simultaneous increases in momentary impulsivity (Law et al., 2016; Sperry, Lynam, & Kwapil,

2018; Tomko et al., 2015). Interestingly, conflicting findings were reported in terms of negative affect temporally predicting impulsivity, with some evidence supporting negative affect prospectively predicting later impulsivity (Depp et al., 2016) and some not (Law et al., 2016).

Only one study (Sperry, Barrantes-Vidal, et al., 2018) investigated baseline temperaments predicting momentary impulsivity scores and found that momentary impulsivity was predicted by higher irritable/cyclothymic temperament scores at baseline. In all, evidence points towards there being some relationship between mood and impulsivity within daily life, although the specific dynamic interaction between the two remains unclear.

Momentary Impulsivity and Substance Use

Seven studies investigated the link between impulsivity and substance use at the day- or momentary-level. Four studies investigated impulsivity as a predictor of substance use (Jones et IMPULSIVITY IN DAILY LIFE 18 al., 2018; Mitchell et al., 2014; Stamates et al., 2019; Treloar Padovano et al., 2019), with three of these four assessing impulsivity’s impact on alcohol use and craving. Two studies found that increased impulsivity in a day related to increased drinking that same day (Jones et al., 2018;

Stamates et al., 2019). Momentary impulsivity was not found to have a relationship with concurrent drinking in any of these studies. Momentary impulsivity interacted with momentary affect to predict alcohol-related outcomes in two studies (Stamates et al., 2019; Treloar

Padovano et al., 2019). Impulsivity assessed in the moment was also used to predict smoking behavior by one study (Mitchell et al., 2014), which showed an interesting parallel to the reported alcohol effects. Impulsivity alone was not a significant predictor of cigarette smoking; however, elevated impulsivity predicted smoking in the context of frustration.

Four studies assessed momentary impulsivity following or in the context of substance use (Ansell et al., 2015; McCarthy et al., 2018; Mitchell et al., 2014; Trull et al., 2016). Studies assessing alcohol’s impact on impulsivity showed diverging results despite using similar impulsivity measures, with one demonstrating that alcohol related to increased impulsivity concurrently and at the day level (Trull et al., 2016), while the other showed no impact of alcohol on impulsivity (Ansell et al., 2015). Studies of the impact of cannabis on impulsivity showed more consistent results. Both studies demonstrated an increase in impulsivity on days when individuals reported smoking relatively more cannabis, but no effects at the momentary or person levels (Ansell et al., 2015; Trull et al., 2016). It should be noted, that because this occurs at the day-level, it’s unclear that impulsivity temporally increased before or after the cannabis use within the day. The remaining two studies predicting impulsivity from substance use investigated the impact of cigarettes. Both reported cigarette smoking related to decreased impulsivity in the moment, measured in terms of momentary ADHD symptoms (Mitchell et al., 2014) and IMPULSIVITY IN DAILY LIFE 19 performance on behavioral tasks (McCarthy et al., 2018). Collectively, these results indicate that substances may have differential effects on impulsivity in the moment.

Momentary Impulsivity and Other Outcomes

Interpersonal interactions. In terms of interpersonal interactions, both close social contact and situational interpersonal triggers predicted increases in momentary impulsivity in clinical samples (Hepp, Carpenter, Lane, & Trull, 2016; Miskewicz et al., 2015). Conversely, one study found that increases in momentary impulsivity predicted more quarrelsome behavior in interpersonal interactions, above/beyond baseline impulsivity (aan het Rot et al., 2015). Some evidence suggests this relationship between momentary impulsivity and interpersonal interactions may function differently across diagnostic groups (Hepp et al., 2016). These results offer preliminary evidence that, across measures of momentary impulsivity and clinical and non- clinical samples, there appears to be a relationship between momentary impulsivity and interpersonal behavior in daily life.

Self-injurious thoughts and behaviors. Three studies included measures of suicidal ideation or non-suicidal self-injury (NSSI). Momentary impulsivity was not related to average frequency of suicidal ideation (Husky et al., 2017), but impulsive urges measured at the daily level did predict NSSI occurrence on a given day (Ammerman et al., 2017). Depp et al. (2016) reported an association between person-level aggregates of momentary impulsivity were related to baseline suicide risk, but they did not report on the relationship between suicide risk and momentary ratings of impulsivity. This is an area ripe for future research.

General functioning. Finally, three studies investigated relationships between impulsivity general functioning, including sleep. Hennig et al. (2017) reported that less total sleep time predicted more daily inattention. Additionally, both day- and person-level impulsivity IMPULSIVITY IN DAILY LIFE 20 ratings were associated with worse problem solving on a given day and with diminished global cognitive function (Roche, 2018; Depp et al., 2016).

Discussion

Measurement Considerations

The compilation of studies included in this review elucidates several points related to the measurement of impulsivity in the moment. First, measures of momentary impulsivity are notably heterogeneous. Within the 25 studies reviewed, 17 distinct measures were used reflecting

15 different conceptualizations of impulsivity. The diversity of these assessments prevented us from drawing broad or generalizable conclusions across studies as many of the effects were measure or domain specific. This issue is not new within personality literature (Evenden, 1999).

Empirical work highlighting meaningful differences among operationalizations of impulsivity

(i.e., jingle fallacy) resulted in a proliferation of multi-dimensional assessments which incorporate multiple aspects of impulsivity in a single measure (e.g., Krueger et al., 2012; Simms et al., 2011; Whiteside & Lynam, 2001). This multi-dimensional movement seems to have extended beyond personality trait research as a majority of the studies in this review utilized momentary multi-dimensional assessments. However, incorporating multiple impulsive constructs into one multi-dimensional measure does not solve necessarily the issue of generalizability. Within this review five distinct multi-dimensional conceptualizations were assessed with eight separate and dissimilar measures. As an illustrative example, three studies

(aan het Rot et al., 2015; Ansell et al., 2015; Pihet et al., 2017) based momentary impulsivity assessments exclusively on the BIS-11 scale. The momentary assessments used in these three studies differed in terms of total number of items, item content, and number of items per facet/domain. While the use of multi-faceted conceptualizations of impulsivity may improve IMPULSIVITY IN DAILY LIFE 21 construct validity within individual studies, using different assessments across studies results in the same generalizability problem as using different monolithic conceptualizations. These issues ultimately invoke measurement concerns (i.e., jingle and jangle fallacies) that have hampered the trait impulsivity literature for decades.

The second measurement issue elucidated by this review regards measurement development. Among the 17 measures used across studies, the most common “measurement development” approach constituted selecting items from a cross-sectional measure and changing the wording to reflect the relevant timeframe. This combined cherry-picking and “cut and paste” approach poses considerable problems for content validity (Clark & Watson, 1995). It is not surprising then that several studies using these measures reported poor convergence between the original cross-sectional measures and the momentary ones. Assessments of momentary impulsivity have not been held to standards for measure development as cross-sectional measures, which should be remedied in future research.

This review also highlighted the issue of psychometrics of momentary assessments of impulsivity. Reported multilevel reliabilities for momentary impulsivity scales overall were within acceptable limits (most being good to excellent). However, across the studies reviewed, between- and within-person reliabilities for a given measure were never reported for more than one sample. This may reflect that investigators tend to develop new measures rather than using existing ones may be interfering and multilevel reliabilities are a relatively novel and advanced statistic with which investigators may not be familiar. Lastly, EMA assessments may not be held to the same reporting standards as cross-sectional ones and not require multi-level reliabilities for publication (although see Trull & Ebner-Priemer, in press). Regardless of the reason, adequate IMPULSIVITY IN DAILY LIFE 22 reporting of multilevel psychometrics is crucial to facilitate the use and dissemination of reliable momentary measures of impulsivity.

Taken together, these findings indicate impulsivity can be conceptualized and measured at momentary and day levels reliably. A primary obstacle to measuring momentary impulsivity reliably is the development and use of measures explicitly for use in EMA or intensive repeated measures designs. There is insufficient evidence currently to support one momentary measure over another in terms of reliability. Additional research that specifically targets developing momentary measures of multi-faceted impulsivity and assessing reliability of those measures across samples and EMA protocols is critically necessary.

Validity

Results of the reviewed studies support the validity of momentary impulsivity in terms of several important components. First, results support the conceptualization of impulsivity as variable within people across time. Across studies a considerable portion of variance in impulsivity scores was accounted for by momentary and day-level influences. Moreover, momentary scores on impulsivity measures were found to fluctuate over time, even within days.

While this finding may seem rudimentary, it confirms that measuring impulsivity at the moment- or day-level is both reasonable and appropriate.

The reviewed studies also support the construct validity of momentary impulsivity, showing that momentary impulsivity is related to important daily life outcomes including negative/positive affect, substance use, interpersonal conflict, and problem solving, in some cases above and beyond person-level baseline impulsivity measures. Though the studies reviewed used various conceptualizations and assessments of momentary impulsivity, results across studies generally suggest that there is a relationship between impulsivity in daily life and IMPULSIVITY IN DAILY LIFE 23 momentary expressions of affect, particularly increased concurrent negative affect. The relationship between impulsivity and substance use was less consistent across studies, but overall results suggest that the relationship between impulsivity and substance use or craving may be moderated by momentary affect and may depend on substance. Finally, results suggest that momentary ratings of impulsivity are related to interpersonal conflict, NSSI, less total sleep time, and diminished cognitive functioning, though fewer total studies investigated the relationships between impulsivity and these other outcomes compared to its relationship with affect and substance use. These results parallel cross-sectional associations between baseline impulsivity and cross-sectional measures of substance use (e.g.,(Coskunpinar, Dir, & Cyders, 2013; Grant,

Lust, Fridberg, King, & Chamberlain, 2019; Kale, Stautz, & Cooper, 2018) psychopathology

(e.g. Henna et al., 2013; McHugh et al., 2019; Tragesser & Robinson, 2009). However, within this review, momentary impulsivity often related to these outcomes above and beyond baseline or trait-based measure of impulsivity. This suggests that assessing impulsivity at a momentary- or daily-level may capture important within-person effects that exist above and beyond person- level or trait-like impulsive tendencies. Overall, the results from the studies reviewed show that measuring impulsivity at the momentary- or day-level meaningfully predicts clinically-relevant emotions and behaviors in participants’ daily lives.

Future Applications/Directions

Given the evidence presented here, assessment of momentary impulsivity holds relevance for numerous areas of interest. The inclusion of measures of momentary impulsivity stands to benefit any area that assesses impulsivity. Diagnostic tools and interventions could be honed based on patterns in momentary impulsivity. Momentary patterns or fluctuations may also be IMPULSIVITY IN DAILY LIFE 24 relevant to diagnostic criteria or stability standards within certain diagnoses. Cognitive and decision-making research may also find utility in this construct.

Perhaps one of the broadest and most promising applications is research and clinical understanding of maladaptive behavior. Research and intervention historically have made blanket assumptions about impulsivity and problematic behaviors, such that it has been assumed that impulsivity always contributes to maladaptive behaviors, particularly among those high in trait measures of impulsivity. However, as results here show, impulsivity (especially person-level impulsivity) does not have blanket influence on behavior. The field stands to gain unprecedented insight into maladaptive behaviors through considering and assessing the impact of fluctuations of impulsivity from moment-to-moment. Furthermore, aspects of participants’ social contexts

(e.g. being at work versus around friends) may constrain or facilitate the expression of impulsivity, and these contexts can be measured from moment-to-moment as well. Research regarding factors that influence changes in momentary impulsivity will likely contribute to clinical conceptualization and intervention.

To maximize on the potential utility of momentary impulsivity in these areas, future research will need to address several limitations of the existing literature. First, as discussed above, standards for measurement development, psychometrics, and reporting must be upheld for daily life studies. Additionally, EMA designs must be tailored to allow adequate power and variance for the analyses necessary to address the research question. Several studies within this review reported intention to assess hypotheses at the momentary level and then aggregated data to the day-level because of issues with power or variability. Notably none of the studies reviewed here included a power analysis in the study manuscript. Recommended methodological and IMPULSIVITY IN DAILY LIFE 25 reporting guidelines for daily life studies were recently summarized by Trull and Ebner-Priemer

(2020) and could be adopted by future studies of impulsivity in daily life.

Conclusions

From our review of the literature, it appears that momentary impulsivity is a valid construct that can be measured reliably. Momentary impulsivity shows good predictive validity in relation to mood, substance use, manifestation of psychopathology symptoms, and interpersonal behavior. Momentary assessments appear to contribute uniquely to predicting clinically-relevant outcomes of interest, even above and beyond cross-sectional measures of impulsivity. Work remains to develop measures of momentary impulsivity specifically for intensive longitudinal designs and validate those measures across multiple samples of interest. IMPULSIVITY IN DAILY LIFE 26

References aan het Rot, M., Moskowitz, D. S., & Young, S. N. (2015). Impulsive behaviour in interpersonal

encounters: Associations with quarrelsomeness and agreeableness. British Journal of

Psychology, 106(1), 152–161. https://doi.org/10.1111/bjop.12070

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental

Disorders (Fifth Edition). https://doi.org/10.1176/appi.books.9780890425596

Ammerman, B. A., Olino, T. M., Coccaro, E. F., & McCloskey, M. S. (2017). Predicting

Nonsuicidal Self-Injury in Borderline Personality Disorder Using Ecological Momentary

Assessment. Journal of Personality Disorders, 31(6), 844–855.

https://doi.org/10.1521/pedi_2017_31_278

Ansell, E. B., Laws, H. B., Roche, M. J., & Sinha, R. (2015). Effects of marijuana use on

impulsivity and hostility in daily life. Drug and Alcohol Dependence, 148, 136–142.

https://doi.org/10.1016/j.drugalcdep.2014.12.029

Bagge, C., Nickell, A., Stepp, S., Durrett, C., Jackson, K., & Trull, T. J. (2004). Borderline

personality disorder features predict negative outcomes 2 years later. Journal of

Abnormal Psychology, 113(2), 279–288. https://doi.org/10.1037/0021-843X.113.2.279

Barrick, M. R., Mount, M. K., & Judge, T. A. (2001). Personality and Performance at the

Beginning of the New Millennium: What Do We Know and Where Do We Go Next?

International Journal of Selection and Assessment, 9(1–2), 9–30.

https://doi.org/10.1111/1468-2389.00160

Berg, J. M., Latzman, R. D., Bliwise, N. G., & Lilienfeld, S. O. (2015). Parsing the heterogeneity

of impulsivity: A meta-analytic review of the behavioral implications of the UPPS for IMPULSIVITY IN DAILY LIFE 27

psychopathology. Psychological Assessment, 27(4), 1129–1146.

https://doi.org/10.1037/pas0000111

Bogg, T., & Roberts, B. W. (2004). Conscientiousness and Health-Related Behaviors: A Meta-

Analysis of the Leading Behavioral Contributors to Mortality. Psychological Bulletin,

130(6), 887–919. https://doi.org/10.1037/0033-2909.130.6.887

Clark, L. A., & Watson, D. (1995). Constructing validity: Basic issues in objective scale

development. Psychological Assessment, 7(3), 309–319. https://doi.org/10.1037/1040-

3590.7.3.309

Conners, C. K., Staff, M. H. S., Connelly, V., Campbell, S., MacLean, M., & Barnes, J. (2000).

Conners’ Continuous Performance Test II (CPT II V.5). Multi-Health Syst Inc, 29, 175–

196.

Coskunpinar, A., Dir, A. L., & Cyders, M. A. (2013). Multidimensionality in impulsivity and

alcohol use: A meta-analysis using the UPPS model of impulsivity. Alcoholism: Clinical

and Experimental Research, 37(9), 1441–1450. https://doi.org/10.1111/acer.12131

Cyders, M. A., & Coskunpinar, A. (2011). Measurement of constructs using self-report and

behavioral lab tasks: Is there overlap in nomothetic span and construct representation for

impulsivity? Clinical Psychology Review, 31(6), 965–982.

https://doi.org/10.1016/j.cpr.2011.06.001

Dawe, S., & Loxton, N. J. (2004). The role of impulsivity in the development of substance use

and eating disorders. Neuroscience & Biobehavioral Reviews, 28(3), 343–351.

https://doi.org/10.1016/j.neubiorev.2004.03.007

Depp, C. A., Moore, R. C., Dev, S. I., Mausbach, B. T., Eyler, L. T., & Granholm, E. L. (2016).

The temporal course and clinical correlates of subjective impulsivity in bipolar disorder IMPULSIVITY IN DAILY LIFE 28

as revealed through ecological momentary assessment. Journal of Affective Disorders,

193, 145–150. https://doi.org/10.1016/j.jad.2015.12.016

DeYoung, C. G. (2011). Impulsivity as a personality trait. In Handbook of self-regulation:

Research, theory, and applications, 2nd ed (pp. 485–502). New York, NY, US: Guilford

Press.

Dick, D. M., Smith, G., Olausson, P., Mitchell, S. H., Leeman, R. F., O’Malley, S. S., & Sher, K.

(2010). Understanding the construct of impulsivity and its relationship to alcohol use

disorders. Addiction Biology, 15(2), 217–226. https://doi.org/10.1111/j.1369-

1600.2009.00190.x

Evenden, J. L. (1999). Varieties of impulsivity. Psychopharmacology, 146(4), 348–361.

https://doi.org/10.1007/PL00005481

Glenn, C. R., & Klonsky, E. D. (2010). A multimethod analysis of impulsivity in nonsuicidal

self-injury. Personality Disorders: Theory, Research, and Treatment, 1(1), 67–75. https://

doi.org/10.1037/a0017427

Grant, J. E., Lust, K., Fridberg, D. J., King, A. C., & Chamberlain, S. R. (2019). E-Cigarette Use

(Vaping) is Associated with Illicit Drug Use, Mental Health Problems, and Impulsivity in

University Students. Annals of Clinical Psychiatry : Official Journal of the American

Academy of Clinical Psychiatrists, 31(1), 27–35.

Griffin, S. A., Lynam, D. R., & Samuel, D. B. (2018). Dimensional conceptualizations of

impulsivity. Personality Disorders: Theory, Research, and Treatment, 9(4), 333–345.

https://doi.org/10.1037/per0000253 IMPULSIVITY IN DAILY LIFE 29

Hamza, C. A., Willoughby, T., & Heffer, T. (2015). Impulsivity and nonsuicidal self-injury: A

review and meta-analysis. Clinical Psychology Review, 38, 13–24.

https://doi.org/10.1016/j.cpr.2015.02.010

Hennig, T., Krkovic, K., & Lincoln, T. M. (2017). What predicts inattention in adolescents? An

experience-sampling study comparing chronotype, subjective, and objective sleep

parameters. Sleep Medicine, 38, 58–63. https://doi.org/10.1016/j.sleep.2017.07.009

Hepp, J., Carpenter, R. W., Lane, S. P., & Trull, T. J. (2016). Momentary symptoms of

borderline personality disorder as a product of trait personality and social context.

Personality Disorders: Theory, Research, and Treatment, 7(4), 384.

Husky, M., Swendsen, J., Ionita, A., Jaussent, I., Genty, C., & Courtet, P. (2017). Predictors of

daily life suicidal ideation in adults recently discharged after a serious suicide attempt: A

pilot study. Psychiatry Research, 256, 79–84.

https://doi.org/10.1016/j.psychres.2017.06.035

Jones, A., Tiplady, B., Houben, K., Nederkoorn, C., & Field, M. (2018). Do daily fluctuations in

inhibitory control predict alcohol consumption? An ecological momentary assessment

study. Psychopharmacology, 235(5), 1487–1496. https://doi.org/10.1007/s00213-018-

4860-5

Kale, D., Stautz, K., & Cooper, A. (2018). Impulsivity related personality traits and cigarette

smoking in adults: A meta-analysis using the UPPS-P model of impulsivity and reward

sensitivity. Drug and Alcohol Dependence, 185, 149–167.

https://doi.org/10.1016/j.drugalcdep.2018.01.003 IMPULSIVITY IN DAILY LIFE 30

Krueger, R. F., Derringer, J., Markon, K. E., Watson, D., & Skodol, A. E. (2012). Initial

construction of a maladaptive personality trait model and inventory for DSM-5.

Psychological Medicine, 42(9), 1879–1890. https://doi.org/10.1017/S0033291711002674

Law, M. K., Fleeson, W., Arnold, E. M., & Furr, R. M. (2016). Using Negative Emotions to

Trace the Experience of Borderline Personality Pathology: Interconnected Relationships

Revealed in an Experience Sampling Study. Journal of Personality Disorders, 30(1), 52–

70. https://doi.org/10.1521/pedi_2015_29_180

Lejuez, C. W., Read, J. P., Kahler, C. W., Richards, J. B., Ramsey, S. E., Stuart, G. L., …

Brown, R. A. (2002). Evaluation of a behavioral measure of risk taking: The Balloon

Analogue Risk Task (BART). Journal of Experimental Psychology: Applied, 8(2), 75–84.

https://doi.org/10.1037/1076-898X.8.2.75

MacLean, R. R., Pincus, A. L., Smyth, J. M., Geier, C. F., & Wilson, S. J. (2018). Extending the

Balloon Analogue Risk Task to Assess Naturalistic Risk Taking via a Mobile Platform.

Journal of Psychopathology and Behavioral Assessment, 40(1), 107–116. https://doi.org/

10.1007/s10862-017-9628-4

McCarthy, D. E., Minami, H., Bold, K. W., Yeh, V. M., & Chapman, G. (2018). Momentary

assessment of impulsive choice and impulsive action: Reliability, stability, and correlates.

Addictive Behaviors, 83, 130–135. https://doi.org/10.1016/j.addbeh.2017.11.031

Miller, J. D., Zeichner, A., & Wilson, L. F. (2012). Personality Correlates of Aggression:

Evidence From Measures of the Five-Factor Model, UPPS Model of Impulsivity, and

BIS/BAS. Journal of Interpersonal Violence, 27(14), 2903–2919.

https://doi.org/10.1177/0886260512438279 IMPULSIVITY IN DAILY LIFE 31

Miskewicz, K., Fleeson, W., Arnold, E. M., Law, M. K., Mneimne, M., & Furr, R. M. (2015). A

Contingency-Oriented Approach to Understanding Borderline Personality Disorder:

Situational Triggers and Symptoms. Journal of Personality Disorders, 29(4), 486–502.

https://doi.org/10.1521/pedi.2015.29.4.486

Mitchell, J. T., Dennis, M. F., English, J. S., Dennis, P. A., Brightwood, A., Beckham, J. C., &

Kollins, S. H. (2014). Ecological Momentary Assessment of Antecedents and

Consequences of Smoking in Adults with Attention-Deficit/Hyperactivity Disorder.

Substance Use & Misuse, 49(11), 1446–1456.

https://doi.org/10.3109/10826084.2014.912229

Muraven, M., & Baumeister, R. F. (2000). Self-regulation and depletion of limited resources:

Does self-control resemble a muscle? Psychological Bulletin, 126(2), 247–259.

https://doi.org/10.1037/0033-2909.126.2.247

Patton, J. H., Stanford, M. S., & Barratt, E. S. (1995). Factor structure of the barratt

impulsiveness scale. Journal of Clinical Psychology, 51(6), 768–774.

https://doi.org/10.1002/1097-4679(199511)51:6<768::AID-JCLP2270510607>3.0.CO;2-

1

Pfohl, B., Blum, N., & Zimmerman, M. (1997). Structured Interview for DSM-IV Personality:

SIDP-IV. American Psychiatric Pub.

Pihet, S., De Ridder, J., & Suter, M. (2017). Ecological Momentary Assessment (EMA) Goes to

Jail: Capturing Daily Antisocial Behavior in its Context, a Feasibility and Reliability

Study in Incarcerated Juvenile Offenders. European Journal of Psychological

Assessment, 33(2), 87–96. https://doi.org/10.1027/1015-5759/a000275 IMPULSIVITY IN DAILY LIFE 32

Roche, M. J. (2018). Examining the alternative model for personality disorder in daily life:

Evidence for incremental validity. Personality Disorders: Theory, Research, and

Treatment, 9(6), 574–583. https://doi.org/10.1037/per0000295

Schmid, J., Stadler, G., Dirk, J., Fiege, C., & Gawrilow, C. (2016). ADHD Symptoms in

Adolescents’ Everyday Life: Fluctuations and Symptom Structure Within and Between

Individuals. Journal of Attention Disorders, 108705471662921.

https://doi.org/10.1177/1087054716629214

Simms, L. J., Goldberg, L. R., Roberts, J. E., Watson, D., Welte, J., & Rotterman, J. H. (2011).

Computerized Adaptive Assessment of Personality Disorder: Introducing the CAT–PD

Project. Journal of Personality Assessment, 93(4), 380–389.

https://doi.org/10.1080/00223891.2011.577475

Spencer, T. J., Biederman, J., & Mick, E. (2007). Attention-Deficit/Hyperactivity Disorder:

Diagnosis, Lifespan, Comorbidities, and Neurobiology. Journal of Pediatric Psychology,

32(6), 631–642. https://doi.org/10.1093/jpepsy/jsm005

Sperry, S. H., Barrantes-Vidal, N., & Kwapil, T. R. (2018). The association of affective

temperaments and bipolar spectrum psychopathology: An experience sampling study.

Motivation and Emotion, 42(1), 126–136. https://doi.org/10.1007/s11031-017-9652-4

Sperry, S. H., Lynam, D. R., & Kwapil, T. R. (2018). The convergence and divergence of

impulsivity facets in daily life. Journal of Personality, 86(5), 841–852.

https://doi.org/10.1111/jopy.12359

Spinella, M., & Miley, W. M. (2003, December 1). Impulsivity and academic achievement in

college students. Retrieved October 21, 2019, from College Student Journal website:

https://link.galegroup.com/apps/doc/A112720418/AONE?sid=lms IMPULSIVITY IN DAILY LIFE 33

Stamates, A. L., Linden-Carmichael, A. N., Preonas, P. D., & Lau-Barraco, C. (2019). Testing

daily associations between impulsivity, affect, and alcohol outcomes: A pilot study.

Addiction Research & Theory, 27(3), 242–248.

https://doi.org/10.1080/16066359.2018.1498846

Tomko, R. L., Carpenter, R. W., Brown, W. C., Solhan, M. B., Jahng, S., Wood, P. K., & Trull,

T. J. (2014). Measuring impulsivity in daily life: The Momentary Impulsivity Scale.

Psychological Assessment, 26(2), 339–349. https://doi.org/10.1037/a0035083

Tomko, R. L., Lane, S. P., Pronove, L. M., Treloar, H. R., Brown, W. C., Solhan, M. B., …

Trull, T. J. (2015). Undifferentiated negative affect and impulsivity in borderline

personality and depressive disorders: A momentary perspective. Journal of Abnormal

Psychology, 124(3), 740.

Treloar Padovano, H., Janssen, T., Emery, N. N., Carpenter, R. W., & Miranda, R. (2019). Risk-

Taking Propensity, Affect, and Alcohol Craving in Adolescents’ Daily Lives. Substance

Use & Misuse, 1–11. https://doi.org/10.1080/10826084.2019.1639753

Trull, T. J., & Ebner-Priemer, U. (2013). Ambulatory Assessment. Annual Review of Clinical

Psychology, 9(1), 151–176. https://doi.org/10.1146/annurev-clinpsy-050212-185510

Trull, T. J., & Ebner-Priemer, U. W. (2020). Ambulatory assessment in psychopathology

research: A review of recommended reporting guidelines and current practices. Journal

of Abnormal Psychology, 129(1), 56.

Trull, T. J., Wycoff, A. M., Lane, S. P., Carpenter, R. W., & Brown, W. C. (2016). Cannabis and

alcohol use, affect and impulsivity in psychiatric out-patients’ daily lives: Cannabis,

alcohol, affect and impulsivity. Addiction, 111(11), 2052–2059.

https://doi.org/10.1111/add.13471 IMPULSIVITY IN DAILY LIFE 34 van der Meere, J. (2005). State Regulation and Attention Deficit Hyperactivity Disorder. In D.

Gozal & D. L. Molfese (Eds.), Attention Deficit Hyperactivity Disorder: From Genes to

Patients (pp. 413–433). https://doi.org/10.1385/1-59259-891-9:413

Verbruggen, F., & Logan, G. D. (2008). Response inhibition in the stop-signal paradigm. Trends

in Cognitive Sciences, 12(11), 418–424. https://doi.org/10.1016/j.tics.2008.07.005

Verdejo-García, A., Lawrence, A. J., & Clark, L. (2008). Impulsivity as a vulnerability marker

for substance-use disorders: Review of findings from high-risk research, problem

gamblers and genetic association studies. Neuroscience & Biobehavioral Reviews, 32(4),

777–810. https://doi.org/10.1016/j.neubiorev.2007.11.003

Whiteside, S. P., & Lynam, D. R. (2001). The five factor model and impulsivity: Using a

structural model of personality to understand impulsivity. Personality and Individual

Differences, 30(4), 669–689.

Wright, A. G. C., & Simms, L. J. (2016). Stability and fluctuation of personality disorder

features in daily life. Journal of Abnormal Psychology, 125(5), 641–656.

https://doi.org/10.1037/abn0000169

Zimmermann, J., Woods, W. C., Ritter, S., Happel, M., Masuhr, O., Jaeger, U., … Wright, A. G.

C. (2019). Integrating structure and dynamics in personality assessment: First steps

toward the development and validation of a personality dynamics diary. Psychological

Assessment, 31(4), 516–531. https://doi.org/10.1037/pas0000625 Table 1. Design features of studies included

Reference Sample N % Mean Duration Timeframe of # Scheduled Event contingent/ % Female Age of EMA prompt (e.g., past 15 assmts. per user-initiated Compliance (SD) period min) day prompts?

1. aan het Rot et Community sample 48 58.33 30.3 20 days N/A 0 Event-contingent N/A (10,014 al. (2015) (7.6) only –interpersonal interpersonal interaction encounters)

2. Ansell et al. Adult drinkers with 43 60.5 23.7 14 days Past day 1 Substance use or 96% (2015) past MJ use (4.6) social interaction

3. Pihet et al. Adolescents in 14.8 103 22 8 days Since the last prompt 4 No 84% (2017) residential (1.1) correction centers

4. Tomko et al. Outpatients with 105 89.5 32.8 28 days Since the last 6 No “Approx. (2014) a BPD or DD (12.2)* completed prompt 90%” 5. Tomko et al. Outpatients with 105 89.5 32.8 28 days Since the last prompt 6 No Average = (2015) a BPD or DD (12.2) 86.0% 6. Hepp et al. Outpatients with 103 100 33.2 28 days Since the last prompt 6 No Average = (2016)a BPD or DD (12.0)* 86.3% 7. Trull et al. Outpatients with 77 85 30.9 28 days Since the last prompt 6 No Average = (2016) a BPD or DD who (11.2) 90.5% used MJ and/or alcohol

8. Stamates et al. Young adult (non- 24 58.3 23.8 14 days “So far today” 1 No Average = (2019) student) drinkers (1.8) 61.9%* 9. Sperry, Lynam, College Students 294 73 18.9 7.5 days “Right now” (3 items) 8 No 62% & Kwapil (oversampled high (2.8) “Since the last beep” (2018) b UPPS-P scores) (3 items)

10. Sperry, College students 290 73 18.9 7 days “Right now” (3 items) 8 No Average = Barrantes- (oversampled high (2.8) “Since the last beep” 66%* Vidal, & HPS scores) (3 items) Kwapil (2018)b 11. Roche (2018) College students 175 78 18.6 14 days Past day 1 (nightly No 88.65%* (1.3) report)

12. Wright & Clinical PD sample 101 65.3 44.9 100 days Past 24 hours 1 (nightly No Average = Simms (2016) c (13.3) diary) 89.5%*

13. Wright et al. Clinical PD sample 101 65.3 44.9 100 days Past 24 hours* 1 (nightly No Average = (2015) c (13.3) diary) 89.5%*

14. Jones et al. Adult heavy 100 54 35.7 14 days N/A – stop signal task 3 Alcohol craving 91.61% (2018) drinkers (9.2) only

15. MacLean et al. Young adult 51 50.98 20.8 7 days N/A – mBART task 4 Cigarette smoking 74% (2018)—Study nondaily smokers (1.7) only 2

16. Treloar Adolescents who 29 55.2 --- 7 days N/A – mBART task --- No --- Padovano et al. drink alcohol at only (2019) least 2x weekly

17. McCarthy et al. Adult smokers 105 47.6 44.8 31 days N/A – behavioral 4 No 69.6% (2018) motivated to quit (12.2) tasks only impulsive smoking choice reports 61.9% impulsive action tasks

18. Hennig et al. Community 61 49.18 15.5 7.5 days “This morning…” 2 No 94%* (2017) adolescents (1.1) “This afternoon…”

19. Mitchell et al. Adult smokers with 17 47.1 32.3 7 days Right now 5-6 Smoking (before/ 94% (2014) ADHD (9.7) after each cigarette)

20. Schmid et al. Adolescents with 166 45.78 13.2 8 days Past day 1 (nightly No 95.20% (2016) and without ADHD (1.9) phone call)

21. Miskewicz et BPD and 255 67.8 44 14 days Past 60 minutes 5 No Average = al. (2015) d community sample (11.2) 63% 22. Law et al. BPD and 255 67.8 44 14 days Past 60 minutes 5 No --- (2016) d community sample (11.2) 23. Ammerman et Adults with BPD 51 74.5 28.8 7 days Right now 4 (phone No On average, al. (2017) and comorbid DD (9.8) calls) completed calls on 78% of days

24. Depp et al. Outpatients with 41 53.7 47 77 days Right now 2 No 65.1% (2016) BP-I or BP-II (12) 25. Husky et al. Adults hospitalized 42 73.8 37.9 7 days Right now 5 No 73.8% (2017) after suicide (12.8) Note. Lettered superscripts indicate manuscripts that originated from the same dataset. Data in individual manuscripts may represent a subset of the same larger dataset. *Indicates the value was not explicitly reported and instead was extrapolated or calculated based on the information provided in the manuscript. MJ=marijuana. ADHD = attention deficit hyperactivity disorder. BP-I = bipolar I disorder. BP-II = bipolar II disorder. BPD = borderline personality disorder. DD = depressive disorder. PD = personality disorder. MIS = Momentary Impulsivity Scale. mBART = momentary Balloon Analogue Risk Task. HPS = Hypomanic Personality Scale. UPPS-P = UPPS Impulsive Behavior Scale. Table 2. Measurement information for included studies Construct name(s) / Impulsivity measure in daily life Full text of Reported Multilevel reliability of Level of Reference operational impulsivity ICCs? impulsivity measure analysis definition(s) items? reported?

1. aan het Rot et Multi-faceted 4 items from BIS-11: “I did/said something without Yes No No M al. (2015) (BIS-11) thinking,” “I acted on impulse,” “I acted on the spur of the moment”

2. Ansell et al. Multi-faceted Daily adaptation of 7 item BIS-brief No 0.56 (D) WP omega = 0.78 D, P (2015) (BIS-11) BP omega = 0.96

3. Pihet et al. Multi-faceted 3 items derived from BIS-11: “I have not paid attention to Yes No WP reliability= 0.53 (3- M, P (2017) (BIS-11) what I was doing,” “I have lost control,” “I have reacted item), 0.62 (2-item) on the spur of the moment” (removed in the 2-item scale) BP reliability= 0.92

4. Tomko et al. Multi-faceted 4 item Momentary Impulsivity Scale (MIS): “I said things Yes No WP reliability RCN = 0.56 M, P a (2014) (BIS-11 and SIDP-IV without thinking,” “I spent more money than I meant to,” BP reliability RKRN = 0.99 BPD criteria) “I felt impatient,” “I made a spur of the moment decision.”

5. Tomko et al. Multi-faceted (MIS) 4-item MIS Yes No No M, D, P (2015) a

6. Hepp et al. Multi-faceted (MIS) 4-item MIS Yes No No M, P (2016) a

7. Trull et al. Multi-faceted (MIS) 4-item MIS No No No M, D, P (2016)a

8. Stamates et Multi-faceted (MIS) 4-item MIS No 0.58 (P) No D, P al. (2019)

9. Sperry, Multi-faceted 3 items assessing impulsivity (e.g. “I am doing something Yes † No WP α = 0.66 M, P Lynam, & (UPPS-P) right now that I may regret later”) BP α= 0.93† Kwapil 3 items assessing impulsive behaviors (e.g. “Since the last (2018) b beep I acted without thinking”)

10. Sperry, Multi-faceted 6 items. [Same as Sperry, Lynam, & Kwapil (2018)] Yes No No M Barrantes- (UPPS-P *) Vidal, & Kwapil (2018) b

11. Roche (2018) Multi-faceted Daily adaptation of 5 Disinhibition items from PID-5- No 0.66 (P) WP α=0.70 D, P (AMPD) Brief Form BP α =0.89

12. Wright & Multi-faceted 2 Urgency items: “I acted on impulse while feeling Yes† 0.41 WP α (Urg.) = 0.82 D, P Simms (2016) (Daily PD upset,” “I acted on my emotions” (Urg.; P) BP α (Urg.) = 0.95 c manifestations) 3 Impulsivity items: “I did something on impulse,” “I did WP α (Imp.) = 0.69 0.33 something dangerous just for the thrill,” “I behaved BP α (Imp.) = 0.82 (Imp.; P) irresponsibly”

13. Wright et al. Multi-faceted 5 items. [Same as Wright & Simms (2016)] Yes No WP α = 0.82 D, P (2015) c (Daily PD BP α = 0.92 manifestations)

14. Jones et al. Inhibitory control Stop Signal Task on smartphones N/A 0.84 (D) Day-level test-retest: α = M, D (2018) 0.96, McDonald’s omega =0.96

15. MacLean et Risk-taking mBART on smartphone. 15 balloons with average break N/A No No M, D, P al. (2018)— propensity point of 64 (out of 128 pumps) Study 2

16. Treloar Risk-taking Single-trial “automatic” mBART task N/A 0.26 (P) No M Padovano et propensity al. (2019)

17. McCarthy et Impulsive choice and Impulsive choice: 8-item delay discounting task N/A 0.58 (P) No M, P al. (2018) impulsive action Impulsive action: 60-66 trial Continuous Performance 0.41 (P) Task

18. Hennig et al. Inattention (ADHD) 3 items: “I had difficulties getting things done,” “I was Yes 0.30 (P) WP α = 0.67 D, P (2017) easily distracted and could not concentrate over a longer BP α = 0.79 period of time,” “My mind shifted or I had daydreams”

19. Mitchell et al. ADHD criteria 18 items reflecting ADHD symptoms (9 for inattention, 9 No No No M (2014) for hyperactivity-impulsivity). 20. Schmid et al. ADHD criteria 11 items assessing ADHD (6 for inattention, 3 for Yes 0.45 (P) WP α = 0.40 D, P (2016) hyperactivity, and 2 for impulsivity) BP α = 0.50

21. Miskewicz et BPD impulsivity 2 items: “I couldn’t stop myself from overdoing Yes No Rc (WP change in imp. M al. (2015) d criteria something bad,” “I had a problem with impulsivity (e.g. symptom) = 0.65 an eating binge, spending spree, drinking too much…)”

† 22. Law et al. BPD impulsivity 2 items. [Same as Miskewicz et al. (2015)] Yes No Rc (WP change in imp. M (2016) d criteria symptom) = 0.65

23. Ammerman “Having impulsive 1 item: “To what extent do you feel this way right now… Yes No No D et al. (2017) urges” impulsive”

24. Depp et al. --- 1 item: “How impulsive do you feel right now?” Yes No No M, P (2016)

25. Husky et al. --- 1 item: intensity of current “impulsive mood state” Yes No No M (2017)

Note. Lettered superscripts indicate manuscripts that originated from the same dataset. Data in individual manuscripts may represent a subset of the same larger dataset. *Indicates that the value was not explicitly reported and instead was extrapolated or calculated based on the information provided in the manuscript. †Information was located in supplementary materials. ICC = intra-class correlation coefficient. M = momentary. D = day. P = person. BIS-11 = Barratt Impulsiveness Scale. AMPD= Alternative Model of Personality Disorders. PID-5 = Personality Inventory for DSM-5. UPPS-P = UPPS Impulsive Behavior Scale. SIDP-IV = Structured Interview for DSM-IV Personality. MIS = Momentary Impulsivity Scale. PD= personality disorder. WP=Within-person. BP= Between-person. Urg.= Urgency. Imp. = Impulsivity. mBART = momentary Balloon Analogue Task. ADHD = attention deficit hyperactivity disorder. BPD = borderline personality disorder. Table 3. Primary findings of studies reviewed

Reference Construct Predictor(s) Outcome(s) Main Findings name / of Interest of Interest operational Momentary-Level Day-Level Person-Level definition

1. aan het Rot et Multi-faceted Impulsivity Interpersonal BIS motor impulsiveness ------al. (2015) (BIS-11) interaction scores (but not attentional impulsiveness or non- Impulsivity planning) predicted event level impulsivity scores. Event level impulsivity scores related to quarrelsomeness in interpersonal interactions.§

2. Ansell et al. Multi-faceted Substance Impulsivity --- MJ use related to increased --- (2015) (BIS-11) use (MJ and impulsivity on the same day alcohol) and following day compared to days without MJ use. No relationship was found for alcohol use.

3. Pihet et al. Multi-faceted -- Measure Approximately half (46%) of --- The 3-item measure of (2017) (BIS-11) development variability in the 3-item scale impulsivity showed good occurred at within-person between-person reliability. Feasibility level. 14% of variance in 3-item impulsivity scale occurred at the between-person level.

4. Tomko et al. Multi-faceted -- Impulsivity Within-person reliability of -- Mean MIS score differed (2014) a (BIS-11 and the MIS was moderate. between BPD and DD groups. Measure SIDP-IV BPD development Within-individual inter-item Those with the DSM-IV-TR criteria) correlations were positive BPD impulsivity criteria among final scale items. showed more instability (higher average MSSDs) of MIS scores. Mean MIS scores correlated significantly with BIS-11 total score, all BIS-11 subscales, UPPS Negative Urgency and Lack of Perseverance.

5. Tomko et al. Multi-faceted Emotion/ Impulsivity Momentary undifferentiated Day-level undifferentiated Average MIS scores (2015) a (MIS) mood negative affect positively negative affect was associated correlated positively with related to momentary with significantly greater day- BIS-11 total score, all BIS-11 impulsivity. level impulsivity. subscales, UPPS lack of Premeditation, UPPS lack of People with BPD reported Perseverance, and UPPS greater momentary Negative Urgency. impulsivity than DD group.

6. Hepp et al. Multi-faceted Interpersonal Impulsivity Close social contact (CSC) --- Person-level impulsivity was (2016) a (MIS) interaction related to increases in negatively correlated with momentary impulsivity. Agreeableness in the BPD group and Conscientiousness In the BPD group, CSC in the DD group. interacted with Extraversion, Agreeableness, and Neuroticism in predicting momentary impulsivity. In the DD group, Conscientiousness had negative effect on impulsivity when CSC was endorsed.

7. Trull et al. Multi-faceted Substance Impulsivity Alcohol use was positively Daily MJ and alcohol use Overall MJ and alcohol use (2016) a (MIS) use (MJ and associated with impulsivity were associated with same were not related to person- alcohol) on the same occasion. day increased impulsivity. level impulsivity ratings.

8. Stamates et al. Multi-faceted Impulsivity Substance --- Daily impulsivity was Aggregated impulsivity (2019) (MIS) use (alcohol) associated with greater odds ratings were not associated Emotion/ of heavy drinking and more with alcohol outcomes. mood alcohol-related problems, but not with drinking intentions, whether/not drank that day, or amount consumed. Daily negative affect didn’t influence the relationship between daily impulsivity and alcohol outcomes. Daily positive affect moderated the relationship between daily impulsivity and drinking intentions.

9. Sperry, Lynam, Multi-faceted Emotion/ Impulsivity Momentary stress, dysphoria, ------& Kwapil (UPPS-P) mood and irritability positively (2018) b related to momentary impulsivity, especially for those high in UPPS negative and positive urgency.§ All UPPS-P facets were positively related to momentary impulsivity.

10. Sperry, Multi-faceted Emotion/ Impulsivity Momentary impulsivity was ------Barrantes- (UPPS-P *) mood not predicted by baseline Vidal, & hyperthymic temperament. Kwapil (2018) b Momentary impulsivity was predicted by lower baseline dysthymic temperament and higher baseline cyclothymic/ irritable temperament.

11. Roche (2018) Multi-faceted Impulsivity Daily --- Daily disinhibition scores Aggregate disinhibition score (AMPD) functioning related to worse problem- positively correlated with (LPFS) solving (“Thinking domain”) baseline disinhibition score. at within-person level. Higher aggregate disinhibition scores related to worse problem-solving.

12. Wright & Multi-faceted -- Impulsivity Impulsivity ratings were Impulsivity ratings were --- Simms (2016) c (Daily PD highly variable across days. stable across months. Measure manifestations) development Baseline PID-5 score did not predict daily impulsivity.

13. Wright et al. Multi-faceted -- Measure --- At the within-person level, a All 5 disinhibition items (2015) c (Daily PD development four-factor model was loaded strongly onto the manifestations) retained. Externalizing domain in the between-person factor All 5 disinhibition items solution. loaded onto the within-person Disinhibition factor. The within-person Disinhibition factor correlated strongly with the Hostility factor (r=.81) and moderately with Negative Affect (r=.61).

14. Jones et al. Inhibitory Impulsivity Substance Momentary inhibitory control An increase in SSRT --- (2018) control use (alcohol) (SSRT scores) didn’t (decrease in inhibitory significantly associate with control) over a day related to alcohol consumption. greater daily alcohol use.§

15. MacLean et al. Risk-taking -- Impulsivity Participants showed more Participants took more risks Lower UPPS sensation (2018)— Study propensity risk-taking on the mBART on the mBART as the study seeking and greater positive Measure 2 when alone than with others. progressed.§ urgency associated with development greater mean variability in mBART. pumps. Males took more risks on mBART than females.

16. Treloar Risk-taking Impulsivity Substance Laboratory BART didn’t ------Padovano et al. propensity use (alcohol predict mBART performance. (2019) craving) Momentary risk taking wasn’t Impulsivity associated with momentary alcohol craving. Higher momentary risk taking strengthened the relationship between momentary positive affect and alcohol craving.§ 17. McCarthy et al. Impulsive Substance Impulsivity Impulsive choice --- Scores on BIS-11 weren’t (2018) choice and use (discounting) increased after related to aggregated impulsive (cigarettes) smoking abstinence for those momentary impulsive choice action high in lab discounting. or impulsive action. Behavioral disinhibition (commission errors on CPT) was lower following smoking than after abstinence.§

18. Hennig et al. Inattention Emotion/ Impulsivity --- Greater total sleep time Adolescents with evening (2017) (ADHD) mood related to lower inattention, chronotype reported more above and beyond other sleep inattention compared with Sleep variables and positive affect. intermediate chronotype.

19. Mitchell et al. ADHD criteria Substance Substance ADHD symptoms weren’t ------(2014) use use elevated prior to smoking. (cigarettes) (cigarettes) Hyperactive-impulsive Impulsivity Impulsivity symptoms were more likely to be elevated prior to smoking in situations perceived as frustrating. All ADHD symptoms were reduced after smoking.

20. Schmid et al. ADHD criteria -- Impulsivity --- ADHD symptoms fluctuated A two-level factor model with (2016) day-to-day. 3 correlated factors (inattention, hyperactivity, General ADHD symptoms and impulsivity), as well as a and specific inattention 2-level bifactor model (with a symptoms seemed to fluctuate general ADHD factor and a independently. specific inattention factor) Two CFA models best fit the provided good fit to the data day level: a 2-level factor at the between-person level. model with 3 correlated factors (hyperactivity, inattention, and impulsivity); and a 2-level bifactor model (general ADHD factor and a specific inattention factor).

21. Miskewicz et BPD Interpersonal Impulsivity Situational triggers (feeling ------al. (2015) d impulsivity interaction rejected, betrayed, etc.) criterion related to momentary impulsivity scores.

22. Law et al. BPD Emotion/ Impulsivity Momentary negative affect ------(2016) d impulsivity mood was associated with higher Emotion/ criterion concurrent endorsement of Impulsivity mood impulsivity. Negative affect didn’t predict impulsivity 3 hours later. Impulsivity did not predict negative affect 3 hours later.

23. Ammerman et “Having Impulsivity NSSI --- Greater impulsive feelings --- al. (2017) impulsive were associated with NSSI urges” occurrence on a given day.

24. Depp et al. --- Impulsivity Emotion/ Negative affect predicted later --- Patients with more severe (2016) mood increases in momentary manic symptoms and greater Emotion/ impulsivity. risk of suicide at baseline had mood Impulsivity higher aggregate impulsivity. Higher momentary Functioning Functioning impulsivity predicted later Greater aggregated decreases in positive affect. impulsivity was associated with worse global cognitive function and more problems with medication adherence.

25. Husky et al. --- Impulsivity Suicidal Momentary impulsivity ------(2017) Ideation wasn’t associated with the average frequency of suicidal ideation. Note. Lettered superscripts indicate manuscripts that originated from the same dataset. Data in individual manuscripts may represent a subset of the same larger dataset. *Indicates that the value was not explicitly reported and instead was extrapolated or calculated based on the information provided in the manuscript. § indicates findings were significant above and beyond baseline measures of impulsivity. MJ = marijuana. LPFS = Level of Personality Functioning Scale. NSSI = nonsuicidal self-injury. ADHD = attention deficit hyperactivity disorder. BPD = borderline personality disorder. DD = depressive disorder. CFA = confirmatory factor analysis. MSSD = mean squared successive difference. SSRT = Stop signal reaction time. BIS-11 = Barratt Impulsiveness Scale. UPPS-P = UPPS Impulsive Behavior Scale. SIDP-IV = Structured Interview for DSM-IV Personality. DSM-IV-TR = Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision. PID-5 = Personality Inventory for DSM-5. CAT-PD = Computerized Adaptive Assessment of Personality Disorder. BART = Balloon Analogue Risk Task. CPT = Continuous Performance Test. MIS = Momentary Impulsivity Scale. mBART = Momentary Balloon Analogue Risk Task. Figure 1. PRISMA Flow Diagram. n o i t a

c Records identified through Additional records identified i f i

t database searching through other sources (citing n e

d (n = 1488) Tomko et al., 2014) I (n = 154)

Records after duplicates removed

g (n = 1557) n i n e e r c S

Records screened Records excluded based (n = 1557) on title/abstract (n = 1518) y t i l

i Full-text articles Full-text articles b i

g assessed for eligibility excluded, with reasons i l

E (n = 39) (n = 14)

Studies included in qualitative synthesis (n = 25)