![Path analysis (c 2 (16) ¼ 20.286, p ¼ .21; root mean square error of approximation ¼ .053, confidence interval ¼ [0, .115]; comparative fit index ¼ .953) including standardized coefficients. Values of the bold single-headed arrows reflect significant standardized regression weights (at the .05 level). The value of the dashed singleheaded arrow reflects a non-significant standardized regression weight. The value of the bold double-headed arrow is a significant correlation (at the .05 level).](https://www.researchgate.net/profile/Martial-Van-Der-Linden/publication/45649506/figure/fig1/AS:340896118788101@1458287376390/Path-analysis-c-2-16-14-20286-p-14-21-root-mean-square-error-of-approximation-14_Q320.jpg)
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The role of urgency and its underlying psychological mechanisms
in problematic behaviours
Joël Billieux
a
,
b
,
*
, Philippe Gay
a
,
b
, Lucien Rochat
a
,
b
, Martial Van der Linden
a
,
b
,
c
a
Cognitive Psychopathology and Neuropsychology Unit, University of Geneva, Geneva, Switzerland
b
Swiss Centre for Affective Sciences, University of Geneva, Geneva, Switzerland
c
Cognitive Psychopathology Unit, University of Liège, Liège, Belgium
article info
Article history:
Received 3 December 2009
Received in revised form
8 June 2010
Accepted 16 July 2010
Keywords:
Urgency
Impulsivity
Inhibition
Decision making
Problematic behaviour
abstract
The urgency facet of impulsivity, that is, the tendency to act rashly in response to intense emotional
contexts [Cyders, M. A., & Smith, G. T. (2008). Emotion-based dispositions to rash action: positive and
negative urgency. Psychological Bulletin, 134, 807e828], has been related to a wide range of maladaptive
behaviours. The present study further investigates the role of urgency in problematic behaviours by
considering distinct psychological mechanisms that may underlie this component of impulsivity. With
this aim, 95 volunteer participants were screened with self-reported questionnaires assessing urgency
and three problematic behaviours (compulsive buying, excessive mobile phone use, excessive Internet
use). They performed two laboratory tasks: a stop-signal task designed to assess the capacity to inhibit
prepotent responses in response to both neutral and emotional stimuli; and the Iowa Gambling Task
(IGT) measuring the ability to take into account the future consequences of an action. A poor ability to
inhibit prepotent responses in the emotional condition of the stop-signal task was found to predict more
disadvantageous choices in the IGT, which ultimately results in higher urgency and more problematic
behaviours. These findings shed new light on the construct of urgency, its related psychological mech-
anisms, and its role in problematic behaviours.
Ó2010 Elsevier Ltd. All rights reserved.
Introduction
Emotions are fundamentally adaptive, as they motivate action
tendencies in response to the environment and trigger behaviours
to attain various goals such as satisfying a need or maintaining
homeostasis (i.e., to reduce the discrepancy between the current
state and the desired state; e.g., Frijda, 1986).
Nevertheless, empirical evidence suggests that emotions do not
always result in adaptive behaviours. Indeed, several studies have
shown that intense emotions may trigger risky or problematic
behaviours (i.e., behaviours that are in discordance with long-term
interests). In particular, research has shown that the experience of
intense negative emotions (e.g., anger, sadness) may promote the
occurrence of problematic behaviours such as binge drinking (e.g.,
Selby, Anestis, & Joiner, 2008), binge eating (e.g., Agras & Telch,
1998; Selby et al., 2008), non-suicidal self-injury (Nock &
Prinstein, 2004), compulsive buying (Miltenberger et al., 2003), or
escapism through excessive use of the Internet (Wan & Chiou,
2006). Investigators have proposed that risky or problematic
behaviours occurring in negative emotional contexts may serve to
relieve or reduce the experience of the negative emotion without
the individual considering the potential negative outcomes of these
behaviours (the self-medication hypothesis; e.g., Colder & Chassin,
1997; Jacobs,1986; Swendsen et al., 2000; Thorberg & Lyvers, 2006;
Tice, Bratslavsky, & Baumeister, 2001). Furthermore, it has been
argued that the proneness to enter into maladaptive behaviours in
a condition of negative affect may be at least partly due to
a weakness of the psychological mechanisms (e.g., executive
functions) involved in the voluntary or controlled regulation of
behaviours (e.g., Tice et al., 2001).
Several authors acknowledge that emotional states impair
executive functioning (Blair et al., 2007; Nock, Wedig, Holmberg, &
Hooley, 2008; Pessoa, 2009), which suggests that persons con-
fronted with intense emotions will have greater difficulty in
exerting active or effortful control (e.g., to inhibit an aggressive
response in response to an emotion of anger). Pessoa (2009) has
proposed that emotional experiences recruit part of the cognitive
resources (e.g., via focusing on the affectively significant stimulus
or the event having triggered the emotional experience) available
for effortful control, which impairs its effectiveness.
*Correspondence to: Joël Billieux, Cognitive Psychopathology and Neuropsy-
chology Unit, FPSE, University of Geneva, Boulevard du Pont d’Arve, 40, CH-1205
Geneva, Switzerland. Tel.: þ41 22 379 93 44; fax: þ41 22 379 93 59.
E-mail address: joel.billieux@unige.ch (J. Billieux).
Contents lists available at ScienceDirect
Behaviour Research and Therapy
journal homepage: www.elsevier.com/locate/brat
0005-7967/$ esee front matter Ó2010 Elsevier Ltd. All rights reserved.
doi:10.1016/j.brat.2010.07.008
Behaviour Research and Therapy 48 (2010) 1085e1096
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Therefore, it could be supposed that the occurrence of prob-
lematic or risky behaviours depends both on individual differences
in executive functioning implicated in effortful control (e.g., inhi-
bition functions, the central executive of the working memory) and
on individual differences in the way people experience the inten-
sity of emotions (emotional reactivity; e.g., see Nock et al., 2008).
From this perspective, the concept of urgencydthe facet of
impulsivity that refers to individual differences in the proneness to
act impulsively and rashly in emotional contexts (see Cyders &
Smith, 2008; Whiteside & Lynam, 2001)dmay reflect a disposi-
tion toward problematic behaviours, depending on the earlier
mentioned psychological mechanisms.
The urgency facet of impulsivity
Researchers have for a decade recognised that impulsivity
reflects a combination of multiple and separable psychological
dimensions (Dick et al., 2010; Enticott & Ogloff, 2006; Evenden,
1999; Whiteside & Lynam, 2001). In an attempt to delimit the
facets underlying impulsivity, Whiteside and Lynam (2001)
administered several widely used questionnaires of impulsivity
and the Revised NEO Personality Inventory (Costa & McCrae, 1992)
to a large sample of undergraduate students. A factor analysis
conducted on these questionnaires resulted in a four-factor solu-
tion, which was the basis for the creation of a scale called the UPPS
Impulsive Behaviour Scale (UPPS). The four dimensions of impul-
sivity measured by the UPPS are (1) urgency, defined as the
tendency to experience strong reactions, frequently under
the condition of negative affect; (2) premeditation, defined as the
tendency to take into account the consequences of an act before
engaging in that act; (3) perseverance, defined as the ability to
remain focused on a task that may be boring and/or difficult; and
(4) sensation seeking, considered as a tendency to enjoy and pursue
activities that are exciting and openness to trying newexperiences.
Interestingly, the distinction between these four self-reported
facets of impulsivity has been confirmed by means of semi-
structured interviews (Smith et al., 2007), which provides conver-
gent validity for this model of impulsivity. Among these various
dimensions of impulsive behaviours, urgency has recently received
increased attention, in particular in the domain of problematic or
maladaptive behaviours (for a review, see Cyders & Smith, 2008).
High levels of self-reported urgency (assessed with the UPPS;
Whiteside & Lynam, 2001) are associated with the occurrence of
a wide range of problematic behaviours, encompassing alcohol and
drug abuse (e.g., Anestis, Selby, & Joiner, 2007; Verdejo-García,
Bechara, Recknor, & Pérez-García, 2007); an increased craving for
cigarettes (Billieux, Van der Linden, & Ceschi, 2007; Doran, Cook,
McChargue, & Spring, 2009); eating disorders (e.g., Fischer,
Anderson, & Smith, 2004); aggressive behaviours (Miller, Flory,
Lynam, & Leukefeld, 2003); borderline symptoms (Miller et al.,
2003); problem gambling (e.g., Smith et al., 2007); compulsive
buying (Billieux, Rochat, Rebetez, & Van der Linden, 2008); and
problematic use of the mobile phone (Billieux, Van der Linden,
d’Acremont, Ceschi, & Zermatten, 2007; Billieux, Van der Linden,
& Rochat, 2008). Moreover, this facet of impulsivity is also the
best predictor of several problematic behaviours when controlling
for other facets of impulsivity and anxiety or depression symptoms
(e.g., Billieux, Rochat, et al., 2008; Billieux, Van der Linden, et al.,
2008). In this context, researchers have recently suggested that
the construct of urgency is a strong indicator of an individual’s
proneness to engage in a variety of maladaptive behaviours to
regulate or relieve negative emotional experience (Cyders & Smith,
2008; Fischer et al., 2004; Selby et al., 2008).
Interestingly, urgency-related behaviours have also been shown
to occur not only in experiences of negative emotions, but also in
contexts of intense positive emotions. Indeed, positive urgency (i.e.,
the tendency to act rashly in intense positive affect) relies on
a variety of problematic behaviours such as problem gambling,
alcohol abuse, or risky sexual behaviour (Cyders & Smith, 2007;
Cyders et al., 2007; Zapolski, Cyders, & Smith, 2009) and has
been proposed to reflect a tendency to enter into problematic
behaviours to regulate positive emotions by maintaining or even
enhancing them (Cyders & Smith, 2008). Of note, strong correla-
tions exist between positive and negative urgency (Cyders et al.,
2007), which suggests that these two facets of impulsivity may
be related to common underlying psychological mechanisms.
Urgency and related psychological mechanisms
Although it is now relatively well established that urgency-
related behaviours often aim to regulate emotions, the specific
psychological mechanisms underlying this facet of impulsivity
remain poorly investigated. The next section provides a review of
the studies that have addressed this topic.
Urgency and the ability to inhibit prepotent responses
Bechara and Van der Linden (2005) initially proposed that
a poor capacity for prepotent response inhibition, that is, the ability
to deliberately control or suppress an automatic response
(Friedman & Miyake, 2004; Miyake et al., 2000), may underlie
urgency. Indeed, this type of inhibition has been considered as
central to the occurrence of impulsive and unplanned behaviours
(e.g., Enticott & Ogloff, 2006; Logan, Schachar, & Tannock,1997) and
has also been found to be impaired in a variety of psychopatho-
logical states characterised by high urgency levels, such as patho-
logical gambling (Goudriaan, Oosterlaan, de Beurs, & Van den Brink,
2006) or alcohol dependence (Noël et al., 2001). The ability to
inhibit prepotent or automatic response is generally assessed via
the “go/no-go”and the “stop-signal”paradigms (see Verbruggen &
Logan, 2008, for a complete description and a consideration of the
differences between these two tasks). In a classical go/no-go task,
the participant has to respond as quickly as possible to a target
stimulus (the “go”trials) presented most of the time (generally 75%
of the trials) and not to respond to another stimulus (the “no-go”
trials) presented less often (generally 25% of the trials). In a stop-
signal task, participants usually perform a choice reaction task (the
“no-stop”trials). On a random part of the trials (generally 25%),
a stop signal (e.g., an auditory tone) is presented. Participants are
instructed not to make the choice reaction task (the “stop”trials)
when the stop signal is presented.
To the best of our knowledge, there are currently only two
studies that have investigated the relationships between self-
reported urgency assessed with the UPPS and inhibition of prepo-
tent responses measured by a go/no-go task (Gay, Rochat, Billieux,
d’Acremont, & Van der Linden, 2008; Perales, Verdejo-Garcia,
Moya, Lozano, & Perez-Garcia, 2009). These studies have obtained
mixed results: Gay et al. (2008) found a significant positive rela-
tionship between urgency and the number of commission errors,
whereas Perales et al. (2009) found no relationship between
urgency and performance on a go/no-go task. From a methodolog-
ical point of view, a direct comparison of these two studies may be
hazardous, as they have been done with distinctive samples.
Indeed, Perales et al. (2009) used a small sample of female under-
graduate students (n¼32) characterised by either high or low
impulsivity scores, whereas Gay et al. (2008) used a larger sample
(n¼126) that was more representative of the general population,
consisting of volunteer participants from the community composed
of a quasi equal number of males and females.
J. Billieux et al. / Behaviour Research and Therapy 48 (2010) 1085e10961086
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With regard to the processes involved in these tasks, a recent
study by Verbruggen and Logan (2008) has shown that go/no-go
tasks allow the development of automatic associative learning across
trials, as the same stimuli are always associated with go/no-go trials.
Thus, only the beginning of the task could be considered as assessing
effortful inhibition (i.e., the moment in which the associative
learning is not yet effective), (.) whereas the remainder of the task
relies on automatic subcortical processes. In contrast, stop-signal
tasks prevent the development of an automatic associative learning,
as target stimuli are inconsistently associated with the stop signal (as
the stop-signal onset follows the appearance of the stimulus).
Consequently, it is likely that the stop-signal task is more suited than
the go/no-go task to measure effortful or cognitive inhibition and
thus to be a better potential candidate to assess one of the suggested
mechanisms underlying the urgency facet of impulsivity.
No studies have explored the relationships between urgency
and the ability to inhibit a prepotent response in emotional situa-
tions (e.g., by using emotional material). This latter point is of
greater importance because, on the one hand, urgency has been
conceptualized as a tendency to act impulsively in an emotional
context (Cyders & Smith, 2008) and, on the other hand, emotional
contexts have been shown to impair the ability to inhibit a prepo-
tent response (Schulz et al., 2007; Verbruggen & De Houwer, 2007).
More specifically, Schulz et al. (2007) have demonstrated by using
a go/no-go task that included faces (with or without an emotional
expression) that it is more difficult to inhibit a prepotent response
for an emotional stimulus than it is for a neutral one, whereas
Verbruggen and De Houwer (2007) found that prepotent response
inhibition (assessed through a stop-signal paradigm) was
compromised when participants viewed high versus low
emotionally arousing pictures. More precisely, emotional scenes of
the International Affective Picture System (Lang, Bradley, &
Cuthbert, 1997) presented before the go and the stop trials of the
task increased the difficulty in successfully inhibiting the prepotent
response. The results of this study support the idea that arousal
induced by emotional pictures (both negative and positive)
increased the difficulty in inhibiting an automatic response, which
could be because highly emotional stimuli (i.e., stimuli with high
arousal properties) automatically draw attentional resources and
interrupt ongoing activities, which in turn results in fewer
resources available for effortful control (e.g., Schimmack, 2005;
Verbruggen & De Houwer, 2007). Therefore, it is possible that
individuals with a higher level of urgency are characterised by
lower inhibition capacities, which make them less able to inhibit
acting rashly in emotional contexts, and/or they experience
emotions more strongly (i.e., they have high emotional reactivity),
which results in increased difficulties in controlling their behav-
iours in such situations.
Urgency may also be underlain by a combination of distinct
psychological processes rather than solely by difficulties in inhib-
iting automatized or prepotent response. Such a hypothesis may
also be supported by the facts that (1) this inhibitory function is
related to several other executive processes (e.g., updating of the
central executive of the working memory, shifting, resistance to
proactive interference; Friedman & Miyake, 2004; Miyake et al.,
2000); and (2) the relationship found by Gay et al. (2008)
between urgency and the ability to inhibit prepotent responses is
of relatively small amplitude, which implies that other psycholog-
ical mechanisms may be related to this facet of impulsivity.
Urgency and the ability to take into account
the consequences of an action
Cyders and Smith (2008) have proposed that urgency-related
behaviours are associated with an elevated focus on the present
moment (e.g., the desire to obtain relief from a negative emotion)
and a reduced focus on long-term consequences, which ultimately
results in maladaptive or risky behaviours. Of note,a majority of the
urgency items of the UPPS explicitly refer to acting without
consideration of future consequences in negative emotional
contexts (e.g., Item 14: “When I feel bad, I will often do things I later
regret in order to make myself feel better now”;Item24:“When I
am upset I often act without thinking”; Item 36: “I often make
matters worse because I act without thinking when I am upset”).
Consequently, it may be hypothesized that high urgency is related
to difficulty in taking into account the future consequences of an
action in emotional contexts; that is, individuals may have
a tendency to make disadvantageous choices in those situations.
The psychological mechanism underlying the ability to make
decisions by considering its future outcomes has been theorized in
the influential “somatic marker hypothesis”theory (Damasio,1994;
Damasio, Tranel, & Damasio, 1991), which argues that in a context
of uncertainty, individuals could unconsciously take into account
the positive and negative outcomes of their actions on the basis of
emotional or somatic markers, that is, anticipatory emotional
reactions provoked by this decision that depend on the conse-
quences associated with similar decisions in the past. From this
perspective, elevated levels of urgency could result in an inability to
act by taking into account somatic markers. Empirical support of
the somatic marker hypothesis is largely based on the findings of
a laboratory-based emotional decision-making task: the Iowa
Gambling Task (IGT; Bechara, Damasio, Damasio, & Anderson,
1994). This task has been developed to factor in several aspects of
real-life decision making such as uncertainty, risk, and evaluation
of rewards and punishments. In the IGT, participants have to select
100 cards from four different decks that are apparently identical.
Each choice leads either to a financial reward or to a combinationof
afinancial reward and a penalty. The two decks are, in fact,
disadvantageous in the long term; that is, they are associated with
greater financial penalty. A central aspect of the IGT, which makes it
relevant for studying urgency-related behaviours, is that in this task
participants have to forego short-term gratification to obtain long-
term profits (by progressively switching their choices from the two
risky decks to the two advantageous decks).
Several authors sustain that the first part of the IGT reflects
decision making under uncertainty, whereas the second part of the
IGT measures decision making under risk (Bechara & Martin, 2004;
Brand, Labudda, & Markowitsch, 2006; Noël, Bechara, Dan, Hanak,
& Verbanck, 2007). Indeed, it has been shown that decisions made
in the IGT progressively switch from uncertain choices involving no
conscious knowledge about reinforcement contingencies of the
decks to choices made in a context in which conscious knowledge
has emerged concerning the reinforcement contingencies of the
various decks (Persaud, McLeod, & Cowey, 2009). Thus, it could be
supposed that the first part of the IGT relies largely on unconscious
processes (e.g., somatic markers), whereas the second part of the
task also recruits effortful conscious processes. Dunn, Dalgleish,
and Lawrence (2006) proposed that the IGT is multi-determined
and relies on various effortful mechanisms, at least in its second
part. These authors proposed that advantageous choices in the IGT
require updating of the content of working memory (to be able to
bear in mind the reward/punishment schedule of the task), inhib-
iting responding to previously rewarding decks, and shifting one’s
preference from risky decks to advantageous decks.
To the best of our knowledge, only four studies have considered
the relationships between the IGT and the various facets of self-
reported impulsivity assessed with the UPPS (Dolan, Bechara, &
Nathan, 2008; Perales et al., 2009; Xiao et al., 2009; Zermatten,
Van der Linden, d’Acremont, Jermann, & Bechara, 2005). These
studies have shown that urgency is associated with less
J. Billieux et al. / Behaviour Research and Therapy 48 (2010) 1085e1096 1087
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advantageous choices in the IGT both in adolescents (Xiao et al.,
2009) and in patients with substance use disorder (Dolan et al.,
2008). Zermatten et al. (2005), however, found that another facet
of impulsivity, namely, lack of premeditation, predicted lower
performance in the IGT. In another study, Perales et al. (2009) found
no relationship between the IGT and the various facets of impul-
sivity. However, several reasons lead us to believe that poor
performance on the IGT should be related to higher levels of
urgency.
First, the IGT has for a long time been conceptualized as a task
that assesses decision making in emotional contexts (e.g., Bechara,
2004; Xiao et al., 2009). This implies that the task is probably more
suited as a reflection of a psychological mechanism underlying the
urgency facet of impulsivity, that is, acting rashly in emotional
contexts, than as a reflection of the lack of premeditation facet of
impulsivity, that is, the capacity to plan and deliberate in general,
not specifically in emotional contexts. Second, it has been shown
that urgency is the facet of impulsivity that better predicts the
occurrence of problematic behaviours characterised by poor
performance in the IGT, such as pathological gambling (e.g.,
Goudriaan, Oosterlaan, de Beurs, & van den Brink, 2005) and
alcohol or drug use (e.g., Bechara et al., 2001; Noël et al., 2007).
Finally, the two studies that did not find a link between the IGT and
urgency used small samples (about 30 participants), and Perales
et al. (2009) incorporated only a small sample of female under-
graduates with high or low impulsivity, which may have had an
impact on the findings. As a consequence, further research remains
necessary to explore the relationships between the IGT and the
urgency facet of impulsivity.
Understanding the role of inhibition and decision making
in urgency manifestations
It seems that both the ability to inhibit prepotent responses and
the capacity to take into account the future consequences of actions
could represent specific psychological mechanisms underlying the
urgency facet of impulsivity. However, it is also possible that these
two mechanisms act conjointly to promote urgency-related
behaviours. Interestingly, recent evidence has shown that poor
ability to inhibit prepotent response predicts a proneness to take
more risky cards in the IGT, especially in the second part of the task,
which represents making choices under risk (Noël et al., 2007;
Shuster & Toplak, 2009). From this perspective, central to our
argument is how inhibition difficulties promote decisions made
without forethought toward future consequences in a situation of
decision making under risk. To this end, an in-depth consideration
of the various processes involved in risky decision making in the
IGT is necessary.
Decision making under risk is a complex process that requires,
on the one hand, consideration of “factual knowledge”about the
choice and, on the other hand, reflection about the potential
consequences of that choice (e.g., Bechara & Van der Linden, 2005).
In reference to the IGT, a crucial question is the nature of the choices
made by the participants in its second part: Do they choose a card
on the basis of unconscious factual knowledge, depending on their
previous choices (i.e., mainly by taking into account information
provided by somatic markers), or do they make choices in accor-
dance with conscious knowledge about the reinforcement contin-
gencies of the various decks? This question is important because if
the participants have acquired conscious knowledge about the IGT,
their choices may also be influenced by controlled or executive
processes (e.g., inhibiting the choice of a card in a deck known to be
risky). In fact, this question has been addressed by Maia and
McClelland (2004), who, by asking participants specific questions
about the game, showed that they acquired conscious conceptual
knowledge about the IGT across trials (e.g., concerning the rein-
forcement contingencies of the four decks). More recently, Persaud
et al. (2009) conducted a study in which participants performed the
IGT and were asked to wager an amount of money after each deck
selection. The hypothesis of the authors is that conscious knowl-
edge about the IGT occurs when participants consistently wage the
maximum amount of money after selecting the positive packs.
Interestingly, this study revealed that advantageous wagering
(which reflects an awareness of the strategy used) began approxi-
mately on trial 70 (13).
From this perspective, it can be postulated that in the second
part of the IGT, the participants have to inhibit responses to
previously rewarding decks (the disadvantageous decks associated
with important positive reinforcements in the beginning of the
task) before being able to make a choice that takes into account the
conscious knowledge they have acquired during the task. Indeed,
the last trials of the IGT require participants to make a choice on the
basis of the factual knowledge they have acquired about the task
(e.g., which decks represent greater gains and/or greater losses) and
also on the basis of the consequences of the choice made (e.g., the
likelihood of going bankrupt after that choice; the consideration of
the amount of money already won or lost). In other words, it is
possible that urgency-related behaviours, considered as rash and
non-deliberated actions in emotional contexts, are promoted by
weakness of the inhibitory control that precludes entering into
areflexive deliberation about an action (e.g., consideration of the
long-term outcomes and not only the immediate reward). From
a more general point of view, the distinction between an automatic
system on the one hand and an analytical or deliberative system on
the other hand (Evans, 2003, 2004; Figner, Mackinlay, Wilkening, &
Weber, 2009) is of much interest when considering urgency-related
behaviours. More precisely, choices resulting from the automatic
system depend on rapid and parallel processes (i.e., they do not
recruit controlled or executive processes) created via associative
learning and which are unconscious until the decision is made. In
contrast, the analytical system is slower and sequential, requires
controlled cognitive processes (such as executive functions and
working memory), and permits abstract and hypothetical thinking
(which is not the case for the automatic system). Thus, it could be
supposed that persons with high urgency have more difficulty
entering into an analytical or deliberative decision-making process,
resulting more frequently in rash and unplanned actions that can
potentially have tangible negative consequences.
The current study
The main goal of the current study was to further investigate the
relations between the urgency facet of impulsivity and both the
capacity to inhibit prepotent responses and the ability to take into
account future consequences of an action. Second, we were also
interested in confirming the critical role of urgency and related
psychological mechanisms in the occurrence of problematic or
risky behaviours. Several a priori hypotheses emerged from our
review and criticism of the existing literature.
First, we postulated that both (1) a lower ability to inhibit
a prepotent response (especially in an emotional context) and (2)
difficulty in taking into account future outcomes when making
a choice in an emotional context predict a higher level of urgency.
As a result of the studies that found that low inhibition capacities
predict poor performance in the IGT, we also examined the possi-
bility that decision making mediates the relation between inhibi-
tion and urgency, that is, whether this latter relation may exist
through the impact of inhibition on the ability to consider long-
term outcomes of an action in the IGT.
J. Billieux et al. / Behaviour Research and Therapy 48 (2010) 1085e10961088
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Second, we expected urgency to predict the involvement in
problematic behaviours, as this dimension of impulsivity has been
related to proneness to act rashly with the desire to relieve negative
emotions (e.g., Cyders & Smith, 2008).
To test these hypotheses, we conducted a study in which
volunteer participants from the community performed two labo-
ratory tasks and completed several self-reported questionnaires.
More precisely, the ability to inhibit prepotent responses was
measured by means of a stop-signal task, using faces with different
facial expressions (neutral, joy, sadness). Human faces with positive
and negative expressions (joy and sadness) were used as
emotionally charged stimuli in the stop-signal task (e.g., see Schulz
et al., 2007, for a study using emotional faces in an inhibition task).
We decided to incorporate both negative and positive stimuli
because Cyders et al. (2007) have shown that urgency-related
behaviours may also occur in response to intense positive
emotions. The ability to take into account the future consequences
of an action in an emotional context was measured with the IGT
(Bechara et al., 1994). The urgency and the lack of premeditation
facets of impulsivity were assessed with the UPPS (Whiteside &
Lynam, 2001). The lack of premeditation facet of impulsivity of
the UPPS was also considered in the current study, as it has
frequently been shown to positively correlate with urgency
(Whiteside & Lynam, 2001; Whiteside, Lynam, Miller, & Reynolds,
2005) and has also been associated with an inability to make
advantageous choices in the IGT (Zermatten et al., 2005). Finally,
three distinct potential problematic behaviours were considered,
namely, compulsive buying, problematic use of the Internet, and
problematic use of the mobile phone. We chose to focus on these
three behaviours for three reasons. First, these types of problematic
behaviours have all been related to high levels of urgency (e.g.,
Billieux, Rochat, et al., 2008; Billieux, Van der Linden, d’Acremont,
et al., 2007). Second, these behaviours have often been consid-
ered as a way to relieve or enhance emotions or moods (e.g., Cyders
& Smith, 2008; Miltenberger et al., 2003; Wan & Chiou, 2006).
Finally, empirical evidence supports these problematic behaviours
to be well represented in non-clinical participants from the
community (e.g., Billieux, Rochat, et al., 2008; Billieux, Van der
Linden, d’Acremont, et al., 2007; Khazaal et al., 2008). The
following self-reported questionnaires were used to assess these
problematic behaviours: the Questionnaire about Buying Behaviour
(QBB; Lejoyeux, Mathieu, Embouazza, Huet, & Lequen, 2007), the
Problematic Use of the Mobile Phone Questionnaire (PUMPQ;
Billieux, Van der Linden, et al., 2008), and the Internet Addiction
Test (IAT; Young, 1999).
Methods
Participants and procedure
Participants were volunteers who received no compensation for
their inclusion in the study. They were recruited by means of
advertisements. The inclusion criterion was being a native speaker
of French. Exclusion criteria were any recent or ongoing major
depressive episode or anxiety disorder, and any reported neuro-
logical disorder. The sample comprised 95 participants (48 females
and 47 males) with an average age of 23.31 years (range 18e30,
SD ¼3.07). The average number of years of education was 14.17
(range 9e20, SD ¼2.13). Participants were individually tested in
a quiet laboratory. They signed an informed consent form before
doing the experiment. Participants performed the stop-signal task
and the IGT (half of the participants performed the stop-signal task
first and the other half performed the Iowa Gambling Task first) and
were then screened with various self-reported questionnaires
assessing impulsivity and problematic behaviours. The order of the
questionnaires was randomized across participants to control for
potential boredom and fatigue effects.
Measures
Emotional Stop-Signal Task
The ability to inhibit prepotent response following the presen-
tation of neutral or emotional stimuli was assessed with a task
inspired from a classical stop-signal paradigm (see Logan, 1994;
Logan et al., 1997). The stimuli used in the task consisted of
human faces with three types of emotional expressions: joy,
neutral, and sadness. All pictures were selected from the Karolinska
Directed Expressional Faces set (KDEF; Goeleven, De Raedt,
Leyman, & Verschuere, 2008; Lundqvist, Flykt, & Öhman, 1998).
The task had two distinct parts. In the first one, used to build up
a prepotent categorization response, participants were presented
with 42 trials in which they had to categorize the gender of faces
(1/3 joy, 1/3 neutral, 1/3 sadness) as quickly as possible without
making mistakes. The cue stimulus (the face) was preceded by
afixation cross displayed for 500 ms, followed by a blank screen
shown for 1000 ms. The second part of the task consisted of two
blocks of 96 trials in which participants were told not to respond
(i.e., to inhibit the prepotent response of gender categorization)
when they heard a computer-emitted tone (25% of the trials), but
otherwise to keep performing the same categorization task as
quickly and accuratelyas possible. In the second part of the task, 32
faces (16 male and 16 female, each with the three different
emotional expressions) of the KDEF were used. Each stimulus was
presented twice (once in the first block and once in the second
block). Stop signals were presented at predetermined intervals
before the subject’s expected response. The length of the interval
before the occurrence of the stop signal was 250 ms, 300 ms,
350 ms, or 400 ms (but two identical intervals were never pre-
sented in sequence). The dependent variable that reflects the
latency of the inhibitory process is the SSRT (see Logan, 1994),
which corresponds to the latency of the inhibitory process (a high
SSRT corresponds to a lower prepotent response inhibition
capacity). The latency of the stop process can be estimated from the
start and finish of the stop process. The start of the stop process is
experimentally controlled by the interval before the occurrence of
the stop signal, but the finish time has to be inferred from the
reaction time distribution in the observed no-stop trials. If
responses are not stopped in n% of the stop trials, the finish of the
stop process is on average equal to the n
th
percentile of the reaction
time distribution in go trials. The stop-signal interval is subtracted
from the n
th
reaction time to estimate SSRT. SSRTs are calculated for
each interval and then averaged. SSRTs are calculated separately for
the neutral, positive, and negative condition. We also computed an
SSRT for the emotional condition by considering the positive and
negative conditions together. Because several of our statistical
analyses could be sensitive to non-normal variables, the SSRTs were
transformed by using natural logarithm to decrease the skewness
of their distribution. Because of technical problems, data for
the stop-signal task are missing for three participants. Paired
sample t-tests revealed no difference in SSRTs between neutral
and emotional conditions, t(91) ¼.92, p¼.36. Inhibition rates
were 72.93% and 71.19% for the neutral and emotional conditions,
respectively. The comparison of the inhibition rates between
neutral and emotional conditions is not significant, t(91) ¼.92,
p¼.36.
Iowa Gambling Task (IGT)
In the IGT (Bechara et al., 1994), participants have to choose one
card at a time from four available decks (A, B, C, and D). The task
requires the participant to make 100 choices (100 trials), and in
J. Billieux et al. / Behaviour Research and Therapy 48 (2010) 1085e1096 1089
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each trial, participants may win or lose a certain amount of money.
The aim is to gain as much money as possible, and the participant
starts the task with 2000 Swiss Francs (of fake money) in his or her
account. During game instruction, participants are told that some
decks are more advantageous than others, but they do not know
which decks are better. Actually, two of the four decks (A and B)
produce immediate large rewards but higher punishment, at
unpredictable points, than the other two decks. In the long run,
decks A and B are disadvantageous. The other two decks (C and D)
produce immediate modest rewards, but lower punishment. These
two decks are advantageous in the long run. To calculate a score
that takes into account the evolution of subjects’choices, we
divided performance into five blocks, representing five periods of
20-card selection. In each block of 20 cards, the number of cards
selected from advantageous decks was calculated (CþD). A score
for each block, as well as a total score, was obtained. Following
recent proposals by Bechara and Martin (2004) and Brand et al.
(2006), we also made the distinction between the initial phase of
the IGT (the first 40 trials), in which participants learn to make
choices but without any explicit knowledge about the reinforce-
ment contingencies of the various decks of the task (decision under
uncertainty), and the second part of the IGT (the 40 last trials), in
which choices become more influenced by explicit knowledge
about the risks associated with each deck (decision under risk).
UPPS Impulsive Behaviour Scale (UPPS)
The French version of the UPPS (Van der Linden et al., 2006),
translated from Whiteside and Lynam (2001), consists of 45 items
that evaluate the four different facets of impulsivity, labelled
negative urgency (12 items, e.g., “When I feel bad, I will often do
things I later regret in order to make myself feel better now”), (lack
of) premeditation (11 items, e.g., “I am a cautious person”), (lack of)
perseverance (10 items, e.g., “I concentrate easily”), and sensation
seeking (12 items, e.g., “I will try anything once”). All items are
scored on a Likert scale from 1 ¼“I agree strongly”to 4 ¼“I disagree
strongly”, with higher scores reflecting higher impulsivity on the
respective facet. A validation study found the high internal
consistency of the French version and its factorial structure to be
similar to the original English UPPS (Van der Linden et al., 2006). In
the present study, internal consistency is very high for the four
facets of impulsivity, namely, negative urgency (Cronbach’s
alpha ¼.85), lack of premeditation (Cronbach’s alpha ¼.81), lack of
perseverance (Cronbach’s alpha ¼.84), and sensation seeking
(Cronbach’s alpha ¼.83).
Problematic Use of the Mobile Phone Questionnaire (PUMPQ)
The PUMPQ (Billieux, Van der Linden, et al., 2008) consists of 30
items measuring four different facets of problematic use of the
mobile phone (prohibited use, dangerous use, financial problems,
and dependence symptoms). The total score of the PUMPQ was
used as a general measure of problematic use of the mobile phone.
All items are scored on a Likert scale from 1 ¼“I agree strongly”to
4¼“I disagree strongly”, with higher scores implying higher
dependence on the mobile phone. The PUMPQ has been shown to
have good psychometrical properties (Billieux, Van der Linden,
et al., 2008). The internal reliability of the PUMPQ in the current
study is very high (Cronbach’s alpha ¼.89).
Questionnaire about Buying Behaviour (QBB)
The QBB (Lejoyeux, Tassain, Solomon, & Adès, 1997) consists of
19 items representing major features of compulsive buying (e.g.,
urges to shop and buy, negative feedback from family and friends,
post-purchase guilt). Items on the scales are scored 0 or 1 (ques-
tions with “yes”or “no”answers). Almost all studies using the QBB
have divided their samples into “compulsive buyers”and “normal
buyers”(Lejoyeux et al., 1997) on the basis of diagnostic criteria for
uncontrolled buying (see McElroy, Keck, Pope, & Smith, 1994) and
on positive answers to certain items of the QBB (e.g., post-purchase
guilt, tangible negative consequences of the purchasing behaviour).
However, in the present study, compulsive buying was conceptu-
alized from a dimensional perspective. Consequently, total scores
on the QBB were considered as reflecting compulsive buying
tendencies, with higher scores reflecting higher compulsive buying
proneness. To the best of our knowledge, no data are available for
the psychometric properties of the QBB. The internal reliability of
the QBB found in the present study is high (Cronbach’s alpha ¼.76).
Internet Addiction Test (IAT)
The French IAT (Khazaal et al., 2008), adapted from Young
(1999), consists of 20 original items assessing the negative conse-
quences of overuse of the Internet (compromised social and indi-
vidual quality of life, compensatory usage of the Internet,
compromised scholarly/academic/working careers, compromised
time control, excitatory usage of the Internet). All items are scored
on a Likert scale (never, rarely, occasionally, often, always) corre-
sponding to scores of 1e
5, with higher scores implying higher
dependence on the Internet. A validation study found the high
internal consistency of the French version and its factorial structure
to be similar to the original English IAT (Khazaal et al., 2008). In the
current study, the internal reliability of the IAT is very high
(Cronbach’s alpha ¼.92).
Statistical analyses
Two-tailed Pearson’s correlations (with 5% significance crite-
rion) were used to evaluate relations between variables. Pearson’s
point-biserial correlation was used to evaluate the effect of gender
on task and questionnaire variables. Women were set at 1 and men
at 2; thus, a positive correlation corresponds to a higher score for
men.
Our various a priori hypotheses were tested by means of path
analysis (PA). PA evaluates the plausibility of a model that is
proposed about the relationships among a set of variables. A benefit
of PA is that it permits the analysis of both direct and indirect
relations between the variables selected. PA analysis was computed
with Mplus by using the Maximum Likelihood statistic test
(Muthén & Muthén, 2006). Participants with missing data (n¼3)
were excluded from the PA. Indirect effects were computed via the
product of coefficient strategy (see Preacher, Rucker, & Hayes, 2007)
provided by Mplus. To test single parameters, we adopted the 5%
significance criterion (i.e., t-value of parameters of 1.96). Model fit
was evaluated using the chi-square (
c
2
) and root mean square error
of approximation (RMSEA) indices. A non-significant
c
2
indicates
a good fit(Byrne, 1994). The RMSEA measures the difference
between the model and the sample data per degree of freedom,
with values below .05 indicating a close fit and below .08 indicating
a reasonable fit(Byrne, 2001). We also reported the comparative fit
index (CFI). A CFI >.90 is generally interpreted as indicating an
acceptable fit.
Results
Summary data of the tasks and the self-report questionnaires
are presented in Table 1.
Correlation analyses
Table 2 reports the two-tailed Pearson’s correlations for all
variables of the study.
J. Billieux et al. / Behaviour Research and Therapy 48 (2010) 1085e10961090
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Correlation analysis revealed several significant relationships
between the various facets of impulsivity. More precisely, we found
positive correlations between negative urgencyand both the lack of
premeditation and perseverance, and between the lack of
premeditation and the lack of perseverance. The sensation seeking
facet of the UPPS did not correlate with the other impulsivity facets.
The urgency facet of impulsivity negatively correlated with both
the total score on the IGT and the last 40 trials of this task. No
correlation was found between negative urgency and the first 40
trials of the IGT. No significant correlation was found between
negative urgency and the SSRTs on the stop-signal task, whether for
the emotional or the neutral conditions. Negative urgency nega-
tively correlated with gender, implying that females were found to
have higher scores on this facet of impulsivity. Finally, negative
urgency positively correlated with the various problematic behav-
iours measured (problematic use of the mobile phone, problematic
use of the Internet, and compulsive buying).
The lack of premeditation and lack of perseverance facets of
impulsivity were not related to the stop-signal task or to the IGT.
However, the lack of premeditation was positively correlated with
the proneness to problematic use of the mobile phone, whereas
the lack of perseverance was positivelycorrelated with the overuse
of the Internet. Nevertheless, the sizes of these two correlations are
smaller compared with those taking place between problematic
behaviours and the negative urgency facet of impulsivity.
A specific relation was found between a high level of sensation
seeking and a better ability to inhibit prepotent responses in the
positive and the emotional conditions of the stop-signal task.
However, no relation occured between sensation seeking and the
neutral and the negative conditions of the stop-signal task, the IGT,
and the various problematic behaviours measured.
From the performance of the tasks, relationships were found
between the IGT and the SSRTs on the stop-signal task. More
specifically, inhibitory capacities for all emotional conditions of the
stop-signal task correlated with total scores on the IGT and with
scores on the last 40 trials of the task. However, no correlation was
found between the ability to inhibit prepotent responses in the
emotional conditions and the IGT scores for the first 40 trials. In
addition, no relationship was found between the ability to inhibit
prepotent responses in the neutral condition and all variables of the
IGT.
Measurement model analyses
Our various a priori hypotheses about the psychological mech-
anisms underlying urgency were tested through PAs. The variables
entered in the model were selected on the basis of our hypotheses
and the correlation analysis. We decided to take into account two
variables for the stop-signal task, namely, the SSRTs for the neutral
condition of the task, and the SSRTs for the emotional conditions.
We chose not to distinguish positive and negative stimuli, as
urgency-related behaviours have been shown to rely on both
positive and negative emotional contexts (see Cyders & Smith,
2008), and the correlations found between inhibition in positive
and negative conditions and the IGTare similar. Concerning the IGT,
we chose to consider only the last 40 trials for three distinct
reasons. First, firm conclusions based on the total score of the IGT
are hazardous, as the beginning and the end of the task appear not
to recruit identical types of psychological mechanisms (e.g., Dunn
et al., 2006; Persaud et al., 2009). Second, advantageous choices
in the second part of the IGT positively correlate with negative
urgency, which is not the case for the advantageous choices in the
first part of the IGT. Third, the ability to inhibit the prepotent
response to emotional stimuli is specifically related to the tendency
to make advantageous choices in the second part of the IGT, not in
Table 1
Descriptives for questionnaires and laboratory tasks.
Variables MSD
Impulsivity facets Negative urgency (UPPS) 26.27 6.24
Lack of premeditation (UPPS) 21.51 4.73
Lack of perseverance (UPPS) 19.28 4.82
Sensation seeking (UPPS) 31.31 7.26
Problematic behaviours Internet (IAT) 27.51 12.30
Mobile phone (PUMPQ) 47.62 12.30
Compulsive buying (QBB) 4.2 3.1
Decision making IGT: total score (trials 1e100) 56.78 15.13
IGT: uncertainty (trials 1e40) 20.49 7.00
IGT: risk (trials 61e100) 24.50 8.23
Prepotent response
inhibition
Stop signal: SSRT-neutral 154.88 54.35
Stop signal: SSRT-positive 155.40 50.60
Stop signal: SSRT-negative 160.38 41.88
Stop signal: SSRT-emotional 157.10 36.80
Note. UPPS ¼UPPS Impulsive Behaviour Scale; IAT ¼Internet Addiction Test;
PUMPQ ¼Problematic Use of the Mobile Phone Questionnaire; QBB ¼Questionnaire
about Buying Behaviour; IGT ¼Iowa Gambling Task; SSRT ¼Stop-Signal Reaction
Time.
Table 2
Pearson’s correlation between the variables.
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15.
1. Age e
2. Gender .22* e
3. UPPS: negative urgency .14 L.30**e
4. UPPS: lack of premeditation .07 .13 .30**e
5. UPPS: lack of perseverance .06 .09 .32** .48*** e
6. UPPS: sensation seeking L.26* .19 .03 .07 .10 e
7. PUMPQ etotal score .01 .16 .44*** .23* .13 .08 e
8. QBB etotal score .10 .13 .47** .10 .16 .04 .46*** e
9. IAT etotal score .14 .01 .30** .03 .24* .01 .14 .26* e
10. IGT: total score .14 .16 L.25*.07 .01 .11 .12 .04 .09 e
11. IGT: trials 1e40 .06 .14 .15 .09 .01 .07 .11 .02 .00 .74*** e
12. IGT: trials 61e100 .10 .13 L.26**.04 .03 .09 .14 .08 .14 .81*** .27** e
13. Stop signal: SSRT-neutral .18 .12 .03 .15 .02 .17 .08 .10 .02 .03 .06 .02 e
14. Stop signal: SSRT-positive .18 .09 .05 .18 .02 L.26* .10 .11 .02 L.33** .20 L.27*.36** e
15. Stop signal: SSRT-negative .06 .02 .09 .09 .11 .15 .12 .06 .04 L.26*.16 L.28*.30** .31** e
16. Stop signal: SSRT-emotional .20 .11 .06 .08 .11 L.22* .10 .06 .13 L.33** .16 L.34** .41*** .78*** .76***
***p<.001; **p<.01; *p<.05.
Note. UPPS ¼UPPS Impulsive Behaviour Scale; PUMPQ ¼Problematic Use of the Mobile Phone Questionnaire; QBB ¼Questionnaire about Buying Behaviour; IAT ¼Internet
Addiction Test; IGT ¼Iowa Gambling Task; SSRT ¼Stop-Signal Reaction Time.
J. Billieux et al. / Behaviour Research and Therapy 48 (2010) 1085e1096 1091
Author's personal copy
its first part. Because correlation analysis revealed that females
have higher negative urgency scores than males have, gender was
incorporated as a moderator in the model. This moderation was
evaluated through the interaction between urgencyand gender and
the effect of urgency and gender on problematic behaviours. To this
end, a new variable was created by multiplying urgency with
gender (value for females ¼1; value for males ¼2). Urgency scores
were centered to reduce potential multicollinearity between the
main effects and interaction effects in the model (Cohen, Cohen,
West, & Aiken, 2003). The lack of premeditation was not incorpo-
rated into the model, as this facet of impulsivity is not related tothe
IGT or to the stop-signal task.
As depicted in Fig. 1, the following causal paths were computed:
(1) paths leading from the prepotent response inhibition capacities
(either in the emotional or neutral conditions) to the ability to make
advantageous decisions under risk; (2) paths leading from the ability
to make advantageous decisions under risk to the negative urgency
and to the interaction between negative urgency and gender; (3)
paths leading from the negative urgency facet of impulsivity to the
various problematic behaviours; (4) pathsleading from gender to the
various problematic behaviours; (5) paths leading from the inter-
action between urgency and gender to the various problematic
behaviours.The following indirect paths werealso computed: (1) the
indirect effect of inhibition (either in the emotional or neutral
conditions) on negative urgency through decision making; and (2)
the indirect effects of decision making on problematic behaviours
through urgency and through the interaction between urgency and
gender. We allowed the inhibition in response to neutral and
emotional stimuli to correlate, as we did for urgency and gender.
The tested model has a good fit(
c
2
(16) ¼20.286, p¼.21;
RMSEA ¼.053, confidence interval ¼[0, .115]; CFI ¼.953). Stan-
dardized regression weights (b) for the structural model are pre-
sented in Fig. 1. The model showedthat (1) the emotional condition
of the stop-signal task predicts the ability to make advantageous
choices in the second part of the IGT (b¼.39), which is not the
case for the neutral condition of the stop-signal task (b¼.13); (2)
the ability to make advantageous choices in the second part of the
IGT predicts the negative urgency facet of impulsivity (b¼-.24); (3)
the negative urgency facet of impulsivity predicts the various
problematic behaviours, namely, compulsive buying (b¼.49),
problematic use of the mobile phone (b¼.48), and problematic use
of the Internet (b¼.34). Problematic behaviours are not signifi-
cantly predicted by gender or by the interaction between the
urgency facet of impulsivity and gender. Moreover, two significant
indirect effects were found: (1) an indirect effect from the
emotional condition of the inhibition task to negative urgency
through decision making under risk (b¼.09); and (2) indirect
effects from decision making under risk to compulsive buying
(b¼.12), problematic use of the mobile phone (b¼.12), and
problematic use of the Internet (b¼.07) through the negative
urgency facet of impulsivity.
Discussion
The aim of the present study was first to investigate the rela-
tions between the urgency facet of impulsivity and two cognitive
mechanismsdthe ability to inhibit a prepotent response and the
capacity to take into account the consequences of an actiondand
second to further confirm the role of urgency in the occurrence of
various problematic or risky behaviours. The results of the study
may be summarized as follows: (1) poor ability to inhibit prepotent
responses in emotional contexts predicts the tendency to make
disadvantageous choices in a situation of decision making under
risk and also indirectly predicts the negative urgency facet of
impulsivity through its effect on the ability to make decisions under
risk; (2) the tendency to make disadvantageous choices in a situa-
tion of decision making under risk predicts the negative urgency
component of impulsivity and also indirectly predicts the occur-
rence of problematic behaviours through its effect on the negative
urgency facet of impulsivity; (3) the negative urgency facet of
impulsivity predicts the occurrence of problematic behaviours; and
(4) being a female is related to higher urgency scores.
The present study shed new light on the role of urgency in
problematic behaviours through a direct investigation of its
underlying psychological mechanisms. Moreover, our data also
confirm and extend previous data highlighting that high urgency is
associated with more risky decisions in the IGT (Dolan et al., 2008;
Xiao et al., 2009). The discussion is divided in two distinct parts.
The first part addresses in detail the question of the psychological
mechanisms underlying urgency, whereas the second part focuses
on the role of urgency in problematic behaviours.
The psychological mechanisms underlying urgency
The main finding of the study was that a low capacity to inhibit
a prepotent response in an emotional context (reflected by the
emotional conditions of the stop-signal task) predicts a proneness
to act without forethought in a situation of decision making under
risk (the second part of the IGT), which ultimately results in more
elevated levels of negative urgency, that is, a proneness to act rashly
in intense negative emotional contexts.
First, our results clarify the role of prepotent response inhibition
in the ability to take into account future consequences of an action.
Indeed, disadvantageous choices in the second part of the IGT were
predicted by a weak capacity to inhibit a prepotent response in the
emotional condition of the stop-signal task but were unrelated to
performances in the neutral condition of that task. This latter
dissociation is all the more interesting as it is, to the best of our
knowledge, the first time that the performances on an emotional
decision-making task have been specifically predicted by the
performances on a task assessing prepotent response inhibition in
an emotional context. Moreover, this result confirms previous
findings highlighting that in the IGT, choices progressively switch
. 41
-. 30
-. 16
-. 04
-. 01
-. 07
. 12 .1 0
. 48 . 49
. 34
-. 39
-. 07
-. 24
. 13
I nhi bi ti on
(n eu tr al co nt ex t)
De ci si on u nde r ri sk
In hi bi ti on
(e mo ti on al co nt ex ts )
Ne ga ti ve
Ur ge nc y
Pr ob le ma ti c
In te rn et
Pr ob le ma ti c
bu yi ng
Pr ob le ma ti c
mo b ile ph on e
Ge nd er
Ne ga ti ve Ur ge nc y x
Ge nd er
Fig. 1. Path analysis (
c
2
(16) ¼20.286, p¼.21; root mean square error of approx-
imation ¼.053, confidence interval ¼[0, .115]; comparative fit index ¼.953) including
standardized coefficients. Values of the bold single-headed arrows reflect significant
standardized regression weights (at the .05 level). The value of the dashed single-
headed arrow reflects a non-significant standardized regression weight. The value of
the bold double-headed arrow is a significant correlation (at the .05 level).
J. Billieux et al. / Behaviour Research and Therapy 48 (2010) 1085e10961092
Author's personal copy
from a context in which risks associated with each choice are
uncertain and mainly associated with unconscious (automatic)
processes to a situation in which risks associated with each choice
become more conscious and depend on controlled or executive
processes (e.g., Brand et al., 2006; Dunn et al., 2006). However, our
results also extend the findings of previous studies by emphasizing
that risky decisions in the IGT arespecifically predicted by difficulty
in inhibiting a prepotent response when faced with emotional
stimuli (and not neutral stimuli). Considering that the IGT is
conceptualized as an emotional decision-making task aimed at
simulating real-life risky situations, that is, a situation in which
a choice has to be made by balancing short-term gratifications with
potential negative future outcomes (Bechara et al., 1994), it is not
surprising that risky choices in this task are specifically predicted
by the ability to inhibit a prepotent response in emotional or “hot”
contexts.
Note that, contrary to the current study, previous studies
reported a relationship between a tendency to make disadvanta-
geous choices in the IGT and poor inhibition capacities that were
assessed with a task using only neutral stimuli (Noël et al., 2007;
Shuster & Toplak, 2009). Nevertheless, this may possibly be
allotted to methodological concerns. In the first study, Noël et al.
(2007) acknowledge that the task they chose to assess prepotent
response inhibition (the Hayling task; Burgess & Shallice, 1996)is
not pure and allows the use of additional conscious strategies (not
related to prepotent response inhibition). Consequently, the multi-
determined task they used to assess inhibition hinders firm
conclusions about the nature of the psychological mechanisms
related to the ability to make advantageous decisions in the IGT. In
the second study, Shuster and Toplak (2009) reported that poor
performances in a go/no-go task (made of neutral stimuli) are
associated with lower abilities to make advantageous choices in the
IGT. In fact, they found a significant relationship between poor
inhibition and lower effective gains in the IGT (i.e., the amount of
hypothetical money won at the end of the task), but not with the
total of number of cards selected in the two advantageous decks C
and D (i.e., the “gold standard”measure in the IGT; Dunn et al.,
2006). This last result is similar to those of the present study.
The present research helps explain why high urgency individ-
uals often act rashly and without forethought in emotional
contexts, although it must be borne in mind that this tendency is
only indirectly related to impairment in the ability to inhibit
a prepotent response. In fact, we hypothesize that individuals with
a high level of urgency often find themselves in emotional contexts
that interfere with their ability to act in a deliberative way, which
ultimately results in actions focused on immediate positive and
negative reinforcement. Indeed, emotional experiences have been
shown to interfere with the effectiveness of inhibitory control
(Schulz et al., 2007), meaning that behaviours occurring in intense
emotional contexts are more often rash, automatic, and unplanned.
Moreover, the greater the degree to which an emotional experience
is intense or arousing (whether positive or negative), the more this
emotional experience is associated with difficulties in inhibiting
a prepotent response (Verbruggen & De Houwer, 2007).
From this perspective, we think that the absence of a direct
relationship between the inhibition task and the negative urgency
facet of impulsivity is possibly due to the stimuli used (faces with
positive or negative expressions) not being highly arousing. In fact,
emotional arousal properties of the pictures from the KDEF
(Goeleven et al., 2008) used in the current study and those from the
International Affective Picture System (IAPS; Lang et al., 1997) used
in the study of Verbruggen and De Houwer (2007) can easily be
compared, as both have been validated with the same procedure.
The arousal provoked by these two types of emotional stimuli was
measured with a 9-point Likert scale ranging from 1 (not at all
arousing)to9(completely arousing). The mean arousal for the KDEF
is 3.72 for happy faces and 3.37 for sad faces (Goeleven et al., 2008),
whereas the mean arousal for the IAPS pictures used by Verbruggen
and De Houwer (2007) is 5.75 for positive pictures and 6.16 for
negative pictures. Thus, it appears that pictures from the IAPS are
more arousing than are the faces of the KDEF. Consequently, if
urgency reflects poor inhibitory control in response to intense
emotions, we likely would have found a higher relationship
between this facet of impulsivity and inhibitory control by using
a stop-signal task designed with more arousing stimuli (such as the
emotional scenes of the IAPS).
Another potential explanation for the absence of a significant
relationship between negative urgency and inhibition capacities is
that individual differences in the way people experience emotions
(i.e., individual differences in emotional reactivity; see Nock et al.,
2008) should have an important impact on their tendency to
urgency manifestations. Indeed, elevated levels of emotional
reactivity (e.g., proneness to experience emotion intensely or for
a prolonged period of time) have been shown to be negatively
correlated with self-assessed inhibitory control (Fabes et al., 1999;
Nock et al., 2008). Accordingly, urgency manifestations may be
promoted by a combination of elevated emotional reactivity and
a diminished ability not to act rashly and without forethought in
the face of intense emotional contexts. Nevertheless, further
studies are necessary to explore the relationships between urgency
and individual differences in emotional reactivity, as this latter
construct was not assessed in the present study.
We found, in addition, a gender effect on the negative urgency
facet of impulsivity, as women had higher scores on this facet of
impulsivity than men. However, this gender effect has already been
found in several studies performed with the UPPS (Billieux, Van der
Linden, et al., 2008; Gay et al., 2008) and is in accordance with
studies highlighting a greater occurrence of self-reported experi-
ences of negative affect in women than in men (Fujita, Diener, &
Sandvik, 1991).
Although the present research focuses on the psychological
mechanisms underlying urgency, we have to discuss here the
unexpected relationship found between sensation seeking and the
stop-signal task. More precisely, persons with a higher level of
sensation seeking are better at inhibiting prepotent responses
when confronted with emotional stimuli (especially positive
stimuli), which raise the relevance of considering the tentative
impact of sensation seeking on cognitive control. To this end, we
found the Dual Mechanisms of Control theory by Braver, Gray, and
Burgess (2007) of much interest. The central hypothesis of these
authors is that when persons activate information relevant to
a goal, cognitive control is likely to operate through two distinct
modes: a proactive control mode and a reactive control mode.
Proactive control implies active maintaining of goal-related infor-
mation in working memory (top-down processes), whereas reac-
tive control is characterised by activation of goal-related
information in reaction to the environmental context when
necessary (bottom-up processes). In this vein, a proactive mode of
cognitive control is probably more suited to perform well at the
stop-signal task. Indeed, active maintaining of the contextual
information relative to the task within working memory may
promote top-down bias (e.g., to exert control on a behaviour that
has become dominant), whereas reactive cognitive control remains
relatively unbiased and more influenced by bottom-up inputs
(implying increased difficulty in inhibiting a behaviour that has
become dominant). Consequently, our hypothesis is that high
sensation seekers will preferentially adopt a proactive mode of
cognitive control when performing the stop-signal task, implying
that they are more efficient in inhibiting behavioural responses that
have been previously automatized. Ultimately, the link between
J. Billieux et al. / Behaviour Research and Therapy 48 (2010) 1085e1096 1093
Author's personal copy
high sensation seeking and better performances in the emotional
conditions of the stop-signal task can tentatively be allotted to the
fact that the adoption of a proactive mode of cognitive control helps
to overcome the emotional interference provoked by arousing
stimuli.
Urgency and problematic behaviours
The present study confirms that the urgency component of
impulsivity plays a crucial role in the occurrence of various prob-
lematic and maladaptive behaviours (Cyders & Smith, 2008, for
a review). More precisely, wefound negative urgency to predict the
occurrence of all of the problematic behaviours assessed, namely,
compulsive buying, problematic use of the mobile phone, and
problematic use of the Internet. Moreover, the current results add
supplementary support to the view that a high level of negative
urgency may result in maladaptive behaviours that serve to regu-
late affective states through the relief of negative emotions (e.g.,
Cyders & Smith, 2008; Selby et al., 2008). Indeed, research has, for
example, highlighted that both compulsive buying and excessive
use of the Internet may serve as behaviours used to cope with or
manage negative affective states (Miltenberger et al., 2003; Wan &
Chiou, 2006). Considering the psychological mechanisms under-
lying the urgency facet of impulsivity, these maladaptive behav-
iours could be viewed as actions performed with the short-term
perspective of emotion management through immediate positive
or negative reinforcement. In other words, and in accordance with
proposals by other researchers (Evans, 2003, 2004; Figner et al.,
2009), our results suggest that these rash actions may take place
when the experience of intense emotions interferes with inhibitory
control and precludes the activation of the demanding analytical or
deliberative processing, which is necessary to consider the imme-
diate benefits in relation to the future costs. Ultimately, it could be
supposed that persons with a higher level of urgency are more at
risk for developing clinically relevant problems (e.g., addictive or
compulsive behaviours) as they become caught in a vicious circle in
which rash or unplanned actions performed in emotional contexts
result in negative outcomes (personal, professional, social),
promoting, in turn, the experience of negative emotions that may
be relieved by overwhelming urgency-related behaviours.
Of particular interest regarding the specificity of the various
impulsivity facets are strong associations between problematic
behaviours and negative urgency; however, the relationships
between these behaviours and lack of premeditation is slim or
non-existent. This finding confirms previous results highlighting
that, contrary to negative urgency, lack of premeditation is not
a predictor of both compulsive buying tendencies and dependence
on the mobile phone when the effect of all impulsivity facets is
controlled (Billieux, Rochat, et al., 2008; Billieux, Van der Linden,
d’Acremont, et al., 2007; Billieux, Van der Linden, et al., 2008).
Thus, in contrast to urgency, a low level of premeditation may
reflect a proneness to act without forethought in general, that is,
not in highly arousing emotional contexts. In fact, it could be
proposed that low premeditators are likely to make disadvanta-
geous decisions because of inadequate or non-adapted delibera-
tive processes (e.g., they do not use all relevant information when
making a decision). Indeed, it has been found that low premedi-
tation is a predictor of certain behaviours or decisions occurring in
less emotional or arousing contexts but which could have tangible
negative long-term consequences. As an example, low premedi-
tation is a predictor of being a smoker (Miller et al., 2003), which
could be considered as a prototypical behaviour implying devas-
tating long-term consequences for health. From this perspective,
starting to smoke could be viewed as the result of a poor delib-
erative process (if deliberation is referred to as a decision making
process that takes into account the balance between short-term
and long-term benefits in the light of all factual relevant infor-
mation available for that decision; Evans, 2003; Figner et al.,
2009). Accordingly, it has been shown that low premeditators
make less advantageous choices than do high premeditators in
a“delay discounting”task in which they have to choose between
a small amount of fake money that is immediately available or
a much higher amount of fake money that is delayed (Lynam &
Miller, 2004). However, among smokers, negative urgency (and
not lack of premeditation) predicts the intensity of craving (i.e.,
the desire to smoke that frequently results in an overwhelming
impulse to smoke) related to the relief from negative affect (e.g., in
response to anxiety, depression, or withdrawal symptoms;
Billieux, Van der Linden, & Ceschi, 2007; Doran et al., 2009). Such
distinctions between urgency and premeditation help explain
their similarities and dissimilarities. Although these two compo-
nents of impulsivity are related to a kind of “myopia”toward long-
term consequences of certain actions, they especially differ in the
sense that they take place in “cold”situations (characterised by
low emotional arousal) versus “hot”situations (characterised by
high emotional arousal). This latter difference may account for the
fact that urgency, rather than lack of premeditation, predicts the
occurrence of a wide range of problematic behaviours performed
with the aim of regulating emotional experiences (e.g., Nock et al.,
2008; Selby et al., 2008).
Limitations
Some limitations of the current study warrant discussion. First,
potential predictions concerning maladaptive behaviours occurring
when individuals experience intense positive emotions are infer-
ential, as positive urgency was not directly assessed in the version
of the UPPS used in the present study. Nevertheless, we found that
a poor ability to inhibit prepotent responses in emotional contexts
(both positive and negative) results in more frequent rash and
short-term based actions (i.e., less advantageous choices in the IGT)
and higher levels of negative urgency. Thus, in accordance with
Cyders et al. (2007), who highlighted by using confirmatory factor
analysis that positive and negative urgency are highly correlated
and load on a common factor of “emotionally based rash actions”
we assume that these two constructs are possibly underlain by
similar psychological mechanisms. Such an explanation could on
the one hand account for the fact that urgency-related behaviours
may be triggered by both positive and negative intense emotional
contexts (Cyders & Smith, 2008) and on the other hand for the very
strong correlations taking place between positive and negative
urgency (e.g.,r¼.67, Verdejo-García, Lozano, Moya, Alcasar, &
Pérez-García, 2010;r¼.67, Zapolski et al., 2009). However, further
research assessing both positive and negative urgency is needed to
empirically test that these two impulsivity facets are underlain by
common psychological mechanisms.
Second, the current study comprises no mood manipulation or
measurement (e.g., pre-, post-, or during the stop-signal task). This
choice was motivated by our wish to investigate the relationship
between urgency and the ability to inhibit a prepotent response in
response to an emotional stimuli and not to induce a mood state in
participants (e.g., through film or music) and then test the partic-
ipants with a classical stop-signal paradigm (not designed with
emotional stimuli). More precisely, on the basis of a conceptuali-
zation of urgency as the tendency to act rashly in response to
emotions (Cyders & Smith, 2008), we found it more relevant to use
a task designed to trigger emotions (the presentation of faces with
positive or negative expression activates the amygdala and related
emotion processing networks, see e.g., Hare, Tottenham, Davidson,
Glover, & Casey, 2005) rather than to induce mood states in the
J. Billieux et al. / Behaviour Research and Therapy 48 (2010) 1085e10961094
Author's personal copy
participants. Indeed, mood states generally refer to an affective
state that is not related to a specific event and that is characterised
by longer duration, lower intensity, and a certain diffuseness
(Frijda, 1993). Nevertheless, we acknowledge that the use of
experimental mood induction is a relevant topic for further
research on urgency, especially considering that urgency-related
problematic behaviours have been associated with not only the
relief of intense negative emotions, but also with the relief of more
stable negative mood states (e.g., Anestis et al., 2007).
Third, the current study is cross-sectional in nature. Thus,
longitudinal studies are needed to investigate whether the
psychological mechanisms related to the urgency facet of impul-
sivity contribute to the progression and maintenance of problem-
atic behaviours. In addition, further research should also consider
the possibility of using more ecological measures to assess prone-
ness to problematic behaviour, rather than being restricted to self-
reports. For example, problematic behaviours could be measured
with diaries in which participants can record behaviours daily
during a certain period. In the framework of research on urgency,
this method is all the more relevant, as participants could be
instructed to pay particular attention to their emotional state
before their involvement in the concerned behaviour.
To summarize, the present study opens new prospects for the
comprehension of mechanisms underlying the urgency facet of
impulsivity and its role in problematic or maladaptive behaviour
(e.g., compulsive buying or overuse of the mobile phone and the
Internet). Ultimately, we think that our findings could be general-
ized to other maladaptive behaviours occurring in response to
intense emotions (e.g., non-suicidal self-injury, risky sex, binge
drinking or eating).
Acknowledgments
We thank Bénédicte Wildhaber, Seraina Agramunt, Sabrina
Dunon, and Séverine Portier for their help in data collection. We
also thank an anonymous reviewer for his relevant comments on an
earlier version of the manuscript.
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