Impulsivity is a common and debilitating sequela following traumatic brain injury (TBI), but there is no consensual definition or measure to assess this construct. The following review aims to elucidate the differences and resemblances between impulsivity, disinhibition and other related terms following brain injury and the instruments that are commonly used to measure these constructs. To do so, a search through different databases was conducted in order to find articles that mention and define impulsivity, disinhibition, impulse control, regulation deficits, dyscontrol and risky behavior. The concepts that stand out from the literature, the measures used, the similarities, the differences between these concepts are observed. The fit with the UPPS model of impulsivity, according to which impulsivity is a multidimensional concept composed of four distinct dimensions (urgency, perseverance, premeditation and sensation-seeking) is discussed.

Negative urgency defined as the tendency to act rashly when faced with intense negative emotions and hostile attribution bias (HAB) which refers to the tendency to interpret the intention of others as hostile when social context cues are ambiguous are two key psychological factors underlying reactive aggression. However, the specific associations between these factors in relation to reactive aggression have not been tested yet with competing models. The objective of the study was to test three putative models: (1) negative urgency moderates the association between HAB and reactive aggression; (2) HAB mediates the link between negative urgency and reactive aggression; (3) negative urgency mediates the relation between HAB and reactive aggression. One-hundred seventy-six participants were given self-report questionnaires to assess impulsivity, reactive aggression, as well as vignettes featuring a social situation measuring HAB in response to an ambiguous social provocation. The results showed that negative urgency constitutes a significant mediator in the association between HAB and reactive aggression. These results provide valuable insight into the cognitive processes underlying reactive aggression and may hold implications for diagnosis and intervention on aggressive behaviors.

Although cognitive distortions are widely acknowledged in the explanation of impulsivity-related psychopathologies (and more recently in the explanation of specific impulsive behaviors), no study has systematically verified whether they can also explain the cognitive processes underlying these impulsivity traits of personality: urgency, lack of premeditation, lack of perseverance, and sensation seeking (UPPS). Moreover, childhood maltreatment has been frequently associated with both cognitive distortions and impulsive behaviors but never with UPPS traits. A study was conducted on undergraduate students to examine the influence of cognitive distortions and childhood maltreatment on four dimensions of impulsivity from the UPPS Impulsive Behavior Scale. Regression analyses revealed that Premature Processing, a term applied to a group of seven cognitive distortions such as emotional reasoning and confusing needs and wants, as well as childhood maltreatment, was able to predict significantly and independently the Negative Urgency dimension of impulsivity, above and beyond gender and the three other subscales of the UPPS Impulsive Behavior Scale. Coherent with Beck’s cognitive model, these results suggest that the Negative Urgency trait is associated with cognitive distortions that can undermine thought processes in a variety of ways, increasing the likelihood of acting rashly. However, more studies are needed to develop instruments and identify specific forms of cognitive distortions associated with impulsivity traits.

Research on cognitive processes has primarily focused on cognitive control and inhibitory processes to the detriment of other psychological processes, such as defense mechanisms (DMs), which can be used to modify aggressive impulses as well as self/other images during interpersonal conflicts. First, we conducted an in-depth theoretical analysis of three socio-cognitive models and three psychodynamic models and compared main propositions regarding the source of aggression and processes that influence its enactment. Second, 32 participants completed the Hostile Expectancy Violation Paradigm (HEVP) in which scenarios describe a hostile vs. non-hostile social context followed by a character's ambiguous aversive behavior. The N400 effect to critical words that violate expected hostile vs. non-hostile intent of the behavior was analyzed. Prepotent response inhibition was measured using a Stop Signal task (SST) and DMs were assessed with the Defense Style Questionnaire (DSQ-60). Results showed that reactive aggression and HIA were not significantly correlated with response inhibition but were significantly positively and negatively correlated with image distorting defense style and adaptive defense style, respectively. The present article has highlighted the importance of integrating socio-cognitive and psychodynamic models to account for the full complexity underlying psychological processes that influence reactive aggressive behavior.