Impulsive Compulsive Behaviours in Older Adults: Rethinking Our Approach To Predictors, Breadth and Assessment

Individuals with Impulsive Compulsive Behaviours (ICBs) experience difficulties in resisting an urge to engage in a reward-based action, resulting in problematic excessive engagement in the behaviour. While seven subtypes of ICBs have been commonly researched as non-motor symptoms in Parkinson’s disease (ICD), the breadth of ICBs, the harm related to them, and the risk factors involved in the development and maintenance of heterogeneous expressions of ICBs have been overlooked in the general population. This cross-sectional study explores ICBs among the general population, highlighting their prevalence in non-clinical populations and proposing a framework for future studies among clinical populations. A sample of 71 older adults from the UK completed a survey comprising seven adapted self-report questionnaires that were proposed as reflective of components of the first model on the addictive cycle of ICBs (I-PACE). Qualitative analyses revealed a variety of behaviours considered problematic among older adults, suggesting that ICBs reflect phenotypical expressions of difficulties with impulse-control, obsessive-compulsivity and substance-use. Correlations between outcome measures of ICBs revealed a strong association between the severity of symptoms and ICB-related harm (i.e., financial, social, health). Principal Component Analyses reduced the dimensionality, while linear regression analyses and between-group ANOVAs explored the key components contributing to ICBs and their subtypes and the main predictors of the ICB-Checklist, SGHS-18 Harm Screen and QUIP-rs. Assessment of ICBs needs to be sensitive to both problematic impulses and compulsions, while their consequences on well-being need to be viewed from a medical and biopsychosocial perspective. Future studies should further explore the risks of obsessions, compulsions and the motivation for ICBs.