Positive Emotion-Based Impulsivity as a Transdiagnostic Endophenotype

Positive emotion-based impulsivity (i.e., positive urgency) is an important impulsivity-related trait associated with a wide range of problematic behaviors and clinical disorders, including substance use, alcohol dependence, pathological gambling, risky sexual behaviors, and non-suicidal self-injurious behaviors, among others. Since its identification in 2007, research has begun to better appreciate how positive emotions bias decision-making and can lead to many of the same negative outcomes that for years were primarily believed to be connected with negative emotional states. However, much still remains to be uncovered about positive urgency, including (a) how best to assess such tendencies without the limitations of self-report biases, (b) how positive urgency imparts risk in specific clinical samples, (c) which mechanisms underlie how positive urgency imparts risk, and (d) how best to intervene on or prevent positive emotion–based risky behaviors. This chapter reviews the accumulating empirical evidence for positive urgency, presents potential mechanisms for how it might affect risk-taking and clinical problems, and discusses many limitations in the current understanding that have thus far made it difficult to identify, prevent, and intervene on this tendency. There are, of course, adaptive and maladaptive features to positive emotions. The extent to which these positive emotions increase risk-taking, however, is an endophenotypic marker of mental health risk across a range of clinical disorders. Better understanding of mechanisms underlying this tendency will lead to identification of novel treatment and prevention targets with broad clinical applicability.