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Self-reported impulsivity and psychiatric history across three Latin American cities: a cross-sectional study in children and adults

This cross-sectional study of children and adults in Bogotá, Pereira, and Arequipa reveals that self-reported impulsivity differences across cities are primarily driven by childhood ADHD history rather than urban context, while also highlighting structural inconsistencies in the adult BIS-11 scale that caution against pooling Latin American populations for cross-cultural research without further psychometric validation.

Original authors: Jorge Avila-Campos, Marcio Soto-Añari, Paula Herrera-Gómez

Published 2026-07-16

📖 6 min read🧠 Deep dive

CC BY 4.0

Original authors: Jorge Avila-Campos, Marcio Soto-Añari, Paula Herrera-Gómez

Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). ✨ This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer

The Impulse Control Gym: A Story of Brains, Cities, and Growing Up

Imagine your brain as a high-performance sports car. Sometimes, you need to hit the gas pedal hard to chase a dream or solve a problem quickly. But other times, you need to slam on the brakes to avoid a crash. This ability to pause, think, and choose your actions instead of just reacting is called impulsivity. In the world of science, researchers study this trait because it's like a common thread that ties together many different mental health challenges, from attention issues to mood swings. It's not just about "being impulsive"; it's about how our brains manage the tension between "I want to do it now" and "I should wait."

Scientists have long wondered if where you live changes how your brain handles these brakes. Does growing up in a bustling, fast-paced city make your internal brakes wear out faster? Or does the environment shape how we express these urges? This question is especially tricky because our brains are still under construction during our teenage years. The prefrontal cortex—the part of the brain responsible for planning and self-control—is like a construction site that doesn't finish until we're in our twenties. So, the rules for a 12-year-old might be totally different from the rules for a 30-year-old. Understanding these differences is crucial because if we mix up the data from kids and adults, or from different cities, we might end up with a blurry picture of what's actually happening in our minds.

The Great Latin American Impulse Check

This study set out to take a snapshot of impulsivity across three distinct Latin American cities: Bogotá and Pereira in Colombia, and Arequipa in Peru. The researchers treated these cities like different "laboratories" to see if the local environment changed how people scored on a famous test called the Barratt Impulsiveness Scale (BIS). Think of this scale as a detailed questionnaire where people rate how often they act without thinking, get distracted, or struggle to plan ahead. The team surveyed nearly 1,300 people, splitting them into two groups: adults (roughly ages 18 to 65) and children/teens (ages 6 to 17). They wanted to see if the city you live in, your age, or your medical history (like past ADHD or depression) made a difference in your "impulse score."

The Adult Mystery: The City Doesn't Matter
When the researchers looked at the adults, the results were surprisingly quiet. After adjusting for age and sex, the city you lived in barely made a dent in the results. Whether an adult was from Bogotá, Pereira, or Arequipa, their impulsivity scores were practically the same. It's as if, by the time we reach adulthood, the specific "vibe" of our city fades into the background, and our personal history takes the wheel.

However, there was a weird glitch in the adult data. The test is usually designed to measure one big "impulsivity" factor, but for these adults, the pieces didn't fit together. The "Non-Planning" part of the test (acting without a plan) actually moved in the opposite direction of the "Attention" and "Motor" parts (getting distracted and acting on impulse). It's like if a thermometer showed that when the temperature went up, the humidity went down, even though they usually rise together. This suggests that for adults in these regions, the test might be measuring a mix of different things rather than one single trait, making it hard to compare their scores directly.

The Teenage Explosion: Pereira Stands Out
The story changed completely when the researchers looked at the children and teenagers. Here, the city mattered a lot. The teens in Pereira scored significantly higher on impulsivity than those in Bogotá or Arequipa. Specifically, the Pereira group scored 12.58 POMP points higher than the Bogotá group. To put that in perspective, that's a huge jump—about the size of one full standard deviation, which is a massive difference in psychological testing.

Why Pereira? The study found that this extra impulsivity was driven mostly by two things: Motor impulsivity (acting physically without thinking) and Non-Planning impulsivity (acting without a future plan). It wasn't just a general "wilder" feeling; it was specific to these two areas. Interestingly, the teens in Arequipa didn't differ much from those in Bogotá.

The ADHD Connection
When the team dug into medical history, they found a clear link. For the children and teens, having a past diagnosis of ADHD was the only factor that remained strongly linked to higher impulsivity scores even after strict statistical checks. Kids with a history of ADHD scored about 13.3 POMP points higher than those without. This makes sense because ADHD is often described as a difficulty with the brain's "brakes."

Other conditions like past depression, bipolar disorder, or schizophrenia showed some links to specific types of impulsivity (mostly the "Non-Planning" kind), but the ADHD connection was the strongest and most consistent. In the adult group, however, none of the medical history factors survived the strict statistical checks. This suggests that the link between mental health history and current impulsivity might be much stronger or more visible during the developmental years of childhood and adolescence.

What This Means
The big takeaway is that impulsivity isn't a one-size-fits-all trait. In adults, where you live doesn't seem to change your score much, and the way we measure it might need a rethink because the different parts of the test don't always move together. But for kids and teens, the environment and their developmental stage are huge factors. The spike in impulsivity in Pereira's teens, combined with the strong link to ADHD, suggests that the teenage years are a critical window where our brains are most sensitive to these influences.

The researchers caution that we can't just lump all Latin American populations together and expect the numbers to match perfectly. The "rules" of impulsivity seem to change as we grow up, and the way we measure them needs to be flexible enough to catch those changes. Before we can say that one city is "more impulsive" than another, we need to make sure our measuring tape works the same way for everyone, regardless of their age or where they live. For now, the evidence points to the teenage years as the most important time to pay attention to these patterns, especially for those with a history of ADHD.

Technical Summary: Self-reported Impulsivity and Psychiatric History Across Three Latin American Cities

Problem Statement
Impulsivity is a well-established transdiagnostic phenotype associated with mood disorders, Attention-Deficit/Hyperactivity Disorder (ADHD), and substance use disorders. While its expression is known to vary across the lifespan, its variation across socio-cultural contexts in Latin America—specifically within urban environments with contrasting socioecological risk profiles—remains largely unexamined. Previous regional studies have suggested differences in impulsivity, particularly in the "Coffee Region" of Colombia, but these findings often lack rigorous control for confounders or fail to account for developmental stages. This study addresses the gap in understanding whether self-reported impulsivity covaries with urban context (Bogotá and Pereira, Colombia; Arequipa, Peru) and psychiatric history across different age groups, while also testing the psychometric validity of pooling data from these diverse populations.

Methodology
The study employed a cross-sectional, multicentric online survey design involving 1,307 participants (898 adults and 409 children/adolescents) recruited via chain-referral sampling and social media in three cities.

Instruments: Adults completed the Barratt Impulsiveness Scale, 11th version (BIS-11), and children/adolescents completed the BIS-11C. Both instruments measure three subscales: Attentional/Cognitive, Motor, and Non-Planning impulsivity.
Data Processing: To enable cross-instrument comparison, raw scores were transformed into a Percentage of Maximum Possible (POMP) metric (0–100).
Statistical Analysis: Associations between impulsivity scores and city, age, sex, and 25 binary clinical antecedents were estimated using Ordinary Least Squares (OLS) regression with HC3 heteroscedasticity-consistent standard errors. P-values were adjusted using the Benjamini–Hochberg False Discovery Rate (FDR) to control for multiple comparisons.
Psychometric Verification: The study assessed composite reliability (Raykov's $\omega$ ) and tested for structural invariance across cities using Box's M test, Levene's test, and Jennrich's $\chi^2$ test. Due to the unavailability of item-level data, these served as approximations for formal measurement invariance.

Key Results

Adults: After adjusting for age and sex, city accounted for negligible variance in total impulsivity scores ( $R^2 = 0.010$ ). No clinical antecedents survived FDR correction. Notably, the BIS-11 structure in adults was inconsistent; the Non-Planning subscale loaded in the opposite direction relative to Attentional and Motor subscales across all cities, suggesting a lack of a unidimensional second-order factor in this adult sample.
Children and Adolescents: Significant cross-city differences were observed. Participants in Pereira scored 12.58 POMP points higher than those in Bogotá ( $p < .001$ ), an effect driven primarily by Motor and Non-Planning dimensions. Arequipa did not differ significantly from Bogotá.
Psychiatric Antecedents: In minors, a history of ADHD was the only antecedent to survive FDR correction for total impulsivity ( $B = +13.3$ POMP points). Subscale-specific associations were found for past depression, bipolar disorder, and schizophrenia within the Non-Planning dimension. In adults, no antecedents survived FDR correction.
Psychometric Invariance: Tests indicated structural non-invariance between cities for both age groups (all Jennrich tests $p < .05$ ), implying that direct comparison of mean scores across these populations requires caution.

Key Contributions

Developmental Specificity: The study demonstrates that cross-city differences in self-reported impulsivity are concentrated in the developmental stage (children/adolescents) rather than adulthood, challenging the assumption of uniform regional effects across the lifespan.
Psychometric Caution: The research provides empirical evidence that the BIS-11 may not function as a unidimensional second-order factor in Latin American adult samples and exhibits structural non-invariance across cities. This highlights the necessity of item-level psychometric testing before pooling Latin American populations in cross-cultural research.
Refined Associations: By applying FDR correction, the study clarifies that many previously reported associations between impulsivity and specific psychiatric antecedents (e.g., family schizophrenia, substance use markers in adults) may have been inflated by Type I error in uncorrected analyses.

Significance and Claims
The authors claim that the observed differences in impulsivity among minors are likely attributable to the high background prevalence of childhood ADHD and bipolar disorder in the Pereira region (part of the Coffee Region), potentially interacting with social risk factors. However, the absence of robust cross-city differences in adults suggests that childhood findings should not be generalized to adult risk profiles.

The paper emphasizes three main implications:

For Research: Future studies must administer item-level instruments and test for measurement invariance before pooling regional samples.
For Clinical Practice: In regions with high prevalence of childhood ADHD and bipolar disorder, screening in minors may identify trajectories warranting early intervention, but adult risk profiles may differ.
For Public Health: Cross-cultural framing of impulsivity must prioritize measurement equivalence over the interpretation of mean score differences as transparent indicators of underlying construct differences.

The study concludes that the mid-adolescent period represents a privileged developmental window for impulsivity-focused interventions, but underscores the need for rigorous psychometric validation before drawing broad cross-cultural conclusions.

The Impulse Control Gym: A Story of Brains, Cities, and Growing Up

The Great Latin American Impulse Check

Technical Summary: Self-reported Impulsivity and Psychiatric History Across Three Latin American Cities

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