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Table 2 Disagreement in assigning an UPPS-P model of impulsivity trait in DSM-5 disorder diagnostic criteria

From: Recommendations for applying a multi-dimensional model of impulsive personality to diagnosis and treatment

  Reason attributed to disagreement
DSM-5 disorder Diagnostic criteria [3] Does not include emotion Focus on wrong trait Confounded by other constructs Multiple traits in criteria Compulsive or impulsive?
 •Bipolar I/II Disorders
 •Major Depressive Disorder
A. …represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.
 9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
     
   X   
Disruptive Mood Dysregulation Disorder A. Severe recurrent temper outbursts manifested verbally (e.g., verbal rages) and/or behaviorally (e.g., physical aggression toward people or property) that are grossly out of proportion in intensity or duration to the situation or provocation.    X X  
 •Bulimia Nervosa
 •Binge Eating Disorder
A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
 2. A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating).
X     
Oppositional Defiant Disorder A. A pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness…., and exhibited during interaction with at least one individual who is not a sibling.      
 1. Often loses temper.    X   
 4. Often actively defies or refuses to comply with requests from authority figures or with rules.    X   
Intermittent Explosive Disorder B. Recurrent behavioral outbursts representing a failure to control aggressive impulses…      
 1. Verbal aggression (e.g., temper tantrums, tirades, verbal arguments or fights) or physical aggression toward property, animals, or other individuals…    X   
 2. The behavioral outbursts involving damage or destruction of property and/or physical assault involving physical injury against animals or other individuals…    X   
Conduct disorder A. A repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated…      
 2. Often initiates physical fights    X X  
 3. Has used a weapon that can cause serious physical harm to others (e.g., a bat, brick, broken bottle, knife, gun).    X X  
 6. Has stolen while confronting a victim (e.g., mugging, purse snatching, extortion, armed robbery)    X X  
 7. Has forced someone into sexual activity    X X  
 10. Has broken into someone else’s house, building, or car    X X  
 12. Has stolen items of nontrivial value without confronting a victim (e.g., shoplifting, but without breaking and entering; forgery)    X X  
 13. Often stays out at night despite parental prohibition, beginning before age 13 years.    X X  
 14. Has run away from home overnight…while living in the parental or parental surrogate home…    X X  
Pyromania B. Tension or affective arousal before act    X   
Kleptomania B. Increasing sense of tension immediately before committing the theft    X   
Substance Use Disorders A. A problematic pattern of substance use leading to clinically significant impairment or distress…   Xa    
 4. Craving, or a strong desire or urge to use [substance] X     
 5. Recurrent [substance] use resulting in a failure to fulfill major role obligations at work, school, or home.      X
 6. Continued [substance] use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of [substance].      X
 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 [substance]      X
Gambling Disorders 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).
  X    
Antisocial Personality Disorder A. A pervasive pattern of disregard for and violation of the rights of others…
 1. Failure to conform to social norms with respect to lawful behaviors, as indicated by repeatedly performing acts that are grounds for arrest.
   X X  
 2. Irritability and aggressiveness, as indicated by repeated physical fights or assaults    X X  
Borderline Personality Disorder A. A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity…      
 5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.    X   
  1. Notes. a = negative and positive urgency is not represented in the diagnostic criteria for substance use disorder, and therefore, no specific diagnostic criteria are currently available to designate