Table 1 Representation of the UPPS-P model of impulsivity in DSM-5 disorder diagnostic criteria

Urgency

Posttraumatic Stress Disorder

E. Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred…:

 1. Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects. (Negative Urgency)

 2. Reckless or self-destructive behavior (Negative Urgency)

Intermittent Explosive Disorder

C. The recurrent aggressive outbursts are not premeditated (i.e., they are impulsive and/or anger-based) and are not committed to achieve some tangible objective (e.g., money, power, intimidation). (Negative Urgency)

Bipolar I/II disorder

B. During the period of mood disturbance and increased energy or activity… are present to a significant degree and represent a noticeable change from usual behaviors:

 7. Excessive involvement in activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments). (Positive Urgency)

Gambling disorder

A. Persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distress…:

 5. Often gambles when feeling distressed (e.g., helpless, guilty, anxious, depressed). (Negative Urgency)

Borderline Personality Disorder

A. A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity…:

 6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days). (Negative Urgency)

 8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights). (Negative Urgency)

Lack of conscientiousness

Attention-Deficit/Hyperactivity Disorder

A. A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development…:

 1. Inattention: …inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities:

  b. Often has difficulty sustaining attention in tasks or play activities (e.g., has difficulty remaining focused during lectures, conversations, or lengthy reading). (Lack of Perseverance)

  d. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in work place (e.g., starts tasks but quickly loses focus and is easily sidetracked). (Lack of Perseverance)

  f. Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (e.g., schoolwork or homework; for older adolescents and adults, preparing reports, completing forms, reviewing length papers). (Lack of Perseverance)

Intermittent Explosive Disorder

C. The recurrent aggressive outbursts are not premeditated (i.e., they are impulsive and/or anger-based) and are not committed to achieve some tangible objective (e.g., money, power, intimidation). (Lack of Premeditation)

Kleptomania

A. Recurrent failure to resist impulses to steal objects that are not needed for personal use or for their monetary value (Lack of Perseverance)

Substance use disorders

A. A problematic pattern of [substance] use leading to clinically significant impairment or distress…:

 1. [Substance] is often taken in larger amounts or over a longer period than was intended. (Lack of Premeditation)

 5. Recurrent [substance] use resulting in a failure to fulfill major role obligations at work, school, or home.

 6. Continued [substance] use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol. (Lack of Premeditation)

 8. Recurrent [substance] use in situations in which it is physically hazardous. (Lack of Premeditation)

 9. [Substance] use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol

Gambling disorder

B. Persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distress…:

 6. After losing money gambling, often returns another day to get even (“chasing” one’s losses). (Lack of Premeditation)

 8. Has jeopardized or lost a significant relationship, job, or educational or career opportunity because of gambling.

Antisocial Personality Disorder

A. A pervasive pattern of disregard for and violation of the rights of others…:

 3. Impulsivity or failure to plan ahead (Lack of Premeditation)

 6. Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations. (Lack of Premeditation)

Sensation seeking

Pyromania

C. Fascination with, interest in, curiosity about, or attraction to fire and its situational contexts (e.g., paraphernalia, uses, consequences).

D. Pleasure, gratification, or relief when setting fires or when witnessing or participating in their aftermath.

Gambling disorder

A. Persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distress…:

 1. Needs to gamble with increasing amounts of money in order to achieve the desired excitement

Borderline Personality Disorder

B. A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity…:

 4. Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating).

Voyeuristic Disorder

A. …recurrent and intense sexual arousal from observing an unsuspecting person who is naked, in the process of disrobing, or engaging in sexual activity, as manifested by fantasies, urges, or behaviors.

Exhibitionistic Disorder

A. …recurrent and intense sexual arousal from the exposure of one’s genitals to an unsuspecting person, as manifested by fantasies, urges, or behaviors

Frotteuristic Disorder

A. …recurrent and intense sexual arousal from touching or rubbing against a nonconsenting person, as manifested by fantasies, urges, or behaviors.

Sexual Sadism Disorder

A. …recurrent and intense sexual arousal from the physical or psychological suffering of another person, as manifested by fantasies, urges, or behaviors.

Pedophilic Disorder

A. …recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child or children (generally age 13 years or younger).

Fetishistic Disorder

A. …recurrent and intense sexual arousal from either the use of nonliving objects or a highly specific focus on non-genital body part(s), as manifested by fantasies, urges, or behaviors

Transvestic Disorder

A. …recurrent and intense sexual arousal from cross-dressing, as manifested by fantasies, urges, or behaviors