BIS-11: Barratt Impulsiveness Scale

Reviewed by: Constantin Rezlescu | Associate Professor | UCL Psychology

Introduction

The Barratt Impulsiveness Scale-11 (BIS-11) is the most widely used self-report measure of impulsiveness in both research and clinical settings. Developed by Ernest Barratt and colleagues (Patton et al., 1995), this 30-item questionnaire represents the culmination of over 50 years of research into the nature and measurement of impulsive behavior. The BIS-11 assesses impulsiveness as a multidimensional construct encompassing motor, attentional, and non-planning aspects of impulsive behavior.

The BIS-11 is the eleventh revision of the Barratt Impulsiveness Scale, which was first developed in 1959. Each revision incorporated new theoretical insights and empirical findings about the nature of impulsivity, with the BIS-11 representing the current standard in impulsivity assessment. It has been translated into over 20 languages and is used worldwide in clinical, research, and forensic settings.

Impulsiveness as a Multidimensional Construct

Ernest Barratt’s pioneering research established that impulsiveness is not a single trait but rather a complex behavioral pattern involving different types of rapid, unplanned reactions to internal and external stimuli. This multidimensional conceptualization distinguishes the BIS-11 from simpler, unidimensional approaches to measuring impulsivity.

Why the multidimensional approach matters:

Different forms of impulsivity have distinct neural substrates, developmental trajectories, and clinical implications. By assessing separate dimensions, the BIS-11 enables:

Precise characterization of impulsivity profiles across different disorders (ADHD shows different patterns than borderline personality disorder)

Targeted interventions addressing specific impulsivity dimensions (attentional vs. motor vs. planning deficits)

Better prediction of specific risk behaviors (motor impulsivity predicts substance abuse; non-planning predicts financial problems)

Understanding mechanisms of how impulsivity operates differently across contexts and populations

Research has demonstrated that the three BIS-11 dimensions show differential relationships with various clinical conditions, personality traits, and behavioral outcomes, validating the multidimensional model.

Theoretical Foundation

The BIS-11 is grounded in Barratt’s neuropsychological model of impulsiveness, which conceptualizes impulsive behavior as arising from deficits in different stages of behavioral control. The three dimensions reflect distinct processes:

Attentional Impulsiveness (Cognitive Instability)

This dimension reflects difficulties in maintaining attention and concentration, with rapid shifts in attention and intrusive thoughts. It captures:

• Inability to focus on tasks at hand
• Cognitive instability and racing thoughts
• Intrusive extraneous thoughts during task performance
• Easily distracted by irrelevant stimuli
• Difficulty with sustained mental effort

Attentional impulsiveness relates to dorsolateral prefrontal cortex function and shows strong associations with ADHD, particularly the inattentive subtype. It represents deficits in executive attention and cognitive control.

Motor Impulsiveness (Motor Disinhibition)

This dimension captures acting without thinking and inability to inhibit behavioral responses. It includes:

• Acting on the spur of the moment
• Doing things without thinking about consequences
• Speaking without thinking
• Difficulty controlling behavior in the moment
• Acting rashly when experiencing strong emotions

Motor impulsiveness relates to orbitofrontal and ventromedial prefrontal function and strongly predicts substance abuse, risky behaviors, and aggression. It represents failures in behavioral inhibition at the response execution stage.

Non-planning Impulsiveness (Self-Control/Planning)

This dimension reflects lack of forethought and future orientation, including:

• Failure to think about or plan for the future
• Lack of careful decision-making
• Focus on present rather than future consequences
• Poor saving behavior and financial planning
• Preference for immediate over delayed rewards

Non-planning impulsiveness relates to more complex executive functions involving temporal discounting and future-oriented thinking. It predicts long-term life outcomes including financial problems, career difficulties, and relationship instability.

These three dimensions are correlated but separable, loading on a higher-order general impulsiveness factor. This hierarchical structure allows both broad trait assessment (total score) and specific dimension profiling (subscale scores).

🎯 Clinical Standard: The BIS-11 is the most frequently used impulsivity measure in clinical research, cited in thousands of studies across diverse psychological and psychiatric conditions.

Key Features

Assessment Characteristics

• 30 items providing comprehensive impulsivity assessment
• 10-15 minutes administration time
• Ages 12+ through adult with separate adolescent and adult norms
• 4-point Likert scale for clear response options
• Three-factor structure measuring distinct but related dimensions
• Total and subscale scores for broad and specific assessment
• Widely available for research with proper attribution

Impulsivity Dimensions Assessed

Attentional Impulsiveness (8 items):

• Concentration difficulties
• Cognitive instability and racing thoughts
• Intrusive extraneous thoughts
• Easy boredom with cognitive tasks

Motor Impulsiveness (11 items):

• Acting without thinking
• Behavioral disinhibition
• Spur-of-the-moment decisions
• Saying things without consideration

Non-planning Impulsiveness (11 items):

• Lack of forethought
• Poor planning and preparation
• Present-focused orientation
• Limited future consideration

Research and Clinical Applications

• ADHD assessment – Key component in attention deficit hyperactivity evaluation
• Substance abuse research – Predicts addiction risk, relapse, and treatment outcomes
• Personality disorder assessment – Central to Cluster B disorder evaluation
• Treatment outcome measurement – Monitors impulse control changes in therapy
• Forensic psychology – Risk assessment and criminal behavior prediction
• Health psychology – Risky health behaviors and decision-making research
• Developmental studies – Tracking impulsivity changes across lifespan

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Assess your impulsivity across attentional, motor, and planning dimensions.

Scoring and Interpretation

Response Format

Participants rate how well each statement describes them using a 4-point Likert scale:

• 1 = Rarely/Never
• 2 = Occasionally
• 3 = Often
• 4 = Almost Always/Always

Sample Items by Dimension

Attentional Impulsiveness (8 items):

• “I don’t pay attention”
• “I concentrate easily” (R)
• “I have trouble concentrating”
• “I often have extraneous thoughts when thinking”
• “I am a careful thinker” (R)

Motor Impulsiveness (11 items):

• “I do things without thinking”
• “I act on impulse”
• “I say things without thinking”
• “I act on the spur of the moment”
• “I buy things on impulse”

Non-planning Impulsiveness (11 items):

• “I plan tasks carefully” (R)
• “I am self-controlled” (R)
• “I plan trips well ahead of time” (R)
• “I save regularly” (R)
• “I am future oriented” (R)

(R) = Reverse scored item

Scoring Procedure

1. Reverse score designated items (reverse score = 5 – original score)
2. Calculate subscale scores:
   • Attentional Impulsiveness: Sum 8 items (range: 8-32)
   • Motor Impulsiveness: Sum 11 items (range: 11-44)
   • Non-planning Impulsiveness: Sum 11 items (range: 11-44)
3. Calculate total score: Sum all 30 items (range: 30-120)
4. Higher scores indicate greater impulsiveness

Score Interpretation

Total BIS-11 Score Classification:

Total Score	Classification	Interpretation
30-52	Low	Below average impulsiveness, good self-control
53-71	Normal	Average levels of impulsive behavior
72-120	High	Above average impulsiveness, potential clinical concern

Subscale Score Interpretation

Attentional Impulsiveness (range: 8-32):

• High scores suggest concentration difficulties and cognitive instability
• Associated with ADHD, particularly inattentive symptoms

Motor Impulsiveness (range: 11-44):

• High scores indicate behavioral disinhibition and hasty actions
• Predicts substance abuse, risky behaviors, and aggression

Non-planning Impulsiveness (range: 11-44):

• High scores reflect poor planning and lack of future orientation
• Associated with financial problems and long-term decision-making difficulties

Clinical Reference Values

Normative samples:

• Healthy adults: M = 63.8, SD = 10.2 (Patton et al., 1995)
• College students: M = 64.5, SD = 9.4 (Stanford et al., 2009)

Clinical populations:

• ADHD adults: M = 68-75 (Malloy-Diniz et al., 2007)
• Substance dependence: M = 70-85 (Stanford et al., 2009)
• Borderline personality disorder: M = 75-85 (Fossati et al., 2001)

Profile Patterns

• High Attentional + Normal Motor: Attention problems without behavioral disinhibition (ADHD inattentive type)
• High Motor + Normal Planning: Impulsive actions but adequate forethought (reactive impulsivity)
• High Non-planning + Normal Motor: Poor planning without immediate behavioral impulsivity (delay discounting, future orientation deficits)
• Elevated across all factors: Generalized impulsivity with multiple manifestations (severe ADHD, antisocial personality disorder)

Research Evidence and Psychometric Properties

Reliability Evidence

• Internal consistency: α = 0.82 for total score demonstrating good reliability (Patton et al., 1995)
• Subscale reliability: α = 0.59-0.74 across three dimensions, adequate for research use (Stanford et al., 2009)
• Test-retest reliability: r = 0.83 over 1-month interval showing good temporal stability (Patton et al., 1995)
• Cross-cultural reliability: Consistent alphas across 20+ language versions (Stanford et al., 2009)

Validity Evidence

Factor structure:

• Three-factor model: Consistently replicated across samples and cultures (Stanford et al., 2009)
• Hierarchical structure: Three first-order factors load on second-order general impulsiveness factor (Patton et al., 1995)
• Cross-cultural validity: Factor structure confirmed in 15+ countries including US, Italy, Brazil, China (Stanford et al., 2009)
• Age invariance: Similar factor structure in adolescent and adult samples (Fossati et al., 2001)

Convergent validity:

• ADHD symptoms: r = 0.65 with ADHD rating scales demonstrating strong relationship (Malloy-Diniz et al., 2007)
• Big Five personality: Expected negative correlations with Conscientiousness (r = -0.50) and Agreeableness (r = -0.30) (Whiteside & Lynam, 2001)
• Behavioral measures: r = 0.30-0.45 with laboratory impulsivity tasks (Go/No-Go, delay discounting) (Reynolds et al., 2006)
• Other impulsivity measures: Strong correlations with UPPS and other self-report impulsivity scales (Whiteside & Lynam, 2001)

Discriminant validity:

• Intelligence: Low correlation (r = -0.15) with IQ measures showing independence from cognitive ability (Patton et al., 1995)
• Anxiety: Low correlation (r = 0.25) distinguishing impulsivity from anxiety (Stanford et al., 2009)

Clinical Group Differentiation

ADHD populations:

• Children with ADHD: M = 71.4 vs. controls M = 59.8, significant difference (Malloy-Diniz et al., 2007)
• Adults with ADHD: M = 68.2 vs. controls M = 55.1 (Patton et al., 1995)
• All three dimensions elevated in ADHD with strongest effects on attentional impulsiveness

Substance use disorders:

• Alcohol dependence: M = 74.5 vs. controls M = 58.7 (Stanford et al., 2009)
• Drug dependence: M = 76.8 vs. controls M = 58.7 (Patton et al., 1995)
• Motor and non-planning dimensions particularly elevated

Personality disorders:

• Borderline PD: M = 79.3 vs. controls M = 58.7, large effect size (Fossati et al., 2001)
• Antisocial PD: M = 75.6 vs. controls M = 58.7 (Stanford et al., 2009)
• All dimensions significantly elevated in Cluster B disorders

Predictive Validity

Treatment outcomes:

• Substance abuse treatment: Higher BIS-11 predicts poorer retention and increased relapse (Moeller et al., 2001)
• ADHD medication response: Baseline impulsivity moderates stimulant treatment effects (Malloy-Diniz et al., 2007)
• Psychotherapy outcomes: Changes in BIS-11 predict therapeutic success (Stanford et al., 2009)

Risk behaviors:

• Suicidal behavior: r = 0.40 with suicide attempt history (Stanford et al., 2009)
• Criminal recidivism: r = 0.35 with re-offense rates (Fossati et al., 2001)
• Risky driving: r = 0.30 with traffic violations and accidents (Stanford et al., 2009)
• Sexual risk-taking: Motor impulsiveness predicts risky sexual behavior (Moeller et al., 2001)

Developmental Research

• Age effects: Moderate decline from adolescence (M = 68) to adulthood (M = 64), continuing through older age (Steinberg et al., 2008)
• Gender differences: Males score 3-5 points higher on average, particularly on motor impulsiveness (Patton et al., 1995)
• Longitudinal stability: Moderate rank-order stability (r = 0.60-0.70) over 2-3 years (Stanford et al., 2009)

Usage Guidelines and Applications

Primary Clinical Applications

• ADHD comprehensive evaluation as component of attention deficit assessment battery
• Substance abuse assessment for risk evaluation and treatment planning
• Personality disorder evaluation particularly for Cluster B disorders (antisocial, borderline)
• Treatment progress monitoring tracking impulse control improvements
• Forensic psychological assessment for risk evaluation and criminal behavior understanding

Clinical Decision Support

Screening and diagnosis:

• Total scores ≥72 warrant comprehensive impulsivity evaluation
• Elevated subscales guide differential diagnosis (ADHD vs. personality disorder)
• Profile patterns inform diagnostic conceptualization

Treatment planning:

• High attentional: Consider ADHD medication, attention training
• High motor: Focus on behavioral inhibition, mindfulness, delay strategies
• High non-planning: Target planning skills, future orientation, goal-setting

Risk assessment:

• Elevated scores indicate increased risk for substance abuse, self-harm, criminal behavior
• Motor impulsiveness particularly predictive of immediate risk behaviors
• Non-planning impulsiveness predicts long-term problematic outcomes

Research Applications

Clinical trials:

• Primary outcome for impulse control interventions
• Secondary outcome for treatments targeting disorders with impulsivity features
• Moderator variable examining who benefits from different interventions

Personality research:

• Individual differences in self-control and behavioral inhibition
• Relationships between impulsivity and other personality dimensions
• Developmental changes in impulse control

Psychopathology studies:

• Role of impulsivity across mental health disorders
• Impulsivity as transdiagnostic risk factor
• Mediator of treatment effects

Intervention Applications

Cognitive-behavioral therapy:

• Target specific dimensions with tailored interventions
• Track symptom reduction through treatment
• Identify high-priority impulsivity domains

Mindfulness-based interventions:

• Particularly effective for attentional impulsiveness
• Monitor improvements in present-moment awareness
• Enhance behavioral inhibition capacity

Medication monitoring:

• Track stimulant effects on ADHD-related impulsivity
• Assess mood stabilizer impacts on impulsive behavior
• Monitor substance abuse treatment pharmaceutical adjuncts

Skills training:

• Executive function training for non-planning impulsiveness
• Social skills training for interpersonal impulsivity
• Financial planning interventions for non-planning deficits

Administration Considerations

• Clinical settings: Administer as part of comprehensive psychological evaluation
• Research contexts: Suitable for group administration and online deployment
• Adolescent use: Appropriate for ages 12+ with developmental interpretation considerations
• Repeated measurement: Track changes every 4-8 weeks during active treatment
• Cultural sensitivity: Consider cultural norms around planning, spontaneity, self-control

Limitations and Cautions

• Self-report bias: May not fully capture actual behavioral impulsivity
• Insight limitations: Low-insight individuals may underreport impulsive behaviors
• State influences: Current mood or circumstances may temporarily affect scores
• Modest subscale reliability: Some factors show internal consistency <0.70
• Behavior gap: Self-perceived impulsivity may diverge from observed behavior
• Cultural interpretation: Items about planning and spontaneity interpreted differently across cultures

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Legal and Copyright Information

Copyright and Usage Responsibility: Check that you have the proper rights and permissions to use this assessment tool in your research. This may include purchasing appropriate licenses, obtaining permissions from authors/copyright holders, or ensuring your usage falls within fair use guidelines.

The BIS-11 is available for research and clinical use with proper attribution to the original authors.

Proper Attribution: When using or referencing this scale, cite the original development:

• Patton, J. H., Stanford, M. S., & Barratt, E. S. (1995). Factor structure of the Barratt Impulsiveness Scale. Journal of Clinical Psychology, 51(6), 768-774.

External Links and Resources

• Impulsivity – Wikipedia
• CHADD – ADHD Resources
• SAMHSA – Substance Abuse Resources
• Association for Behavioral and Cognitive Therapies

References

Primary Development Citation:

• Patton, J. H., Stanford, M. S., & Barratt, E. S. (1995). Factor structure of the Barratt Impulsiveness Scale. Journal of Clinical Psychology, 51(6), 768-774.

Comprehensive Review:

• Stanford, M. S., Mathias, C. W., Dougherty, D. M., Lake, S. L., Anderson, N. E., & Patton, J. H. (2009). Fifty years of the Barratt Impulsiveness Scale: An update and review. Personality and Individual Differences, 47(5), 385-395.

Validation Research:

• Fossati, A., Di Ceglie, A., Acquarini, E., & Barratt, E. S. (2001). Psychometric properties of an Italian version of the Barratt Impulsiveness Scale-11 (BIS-11) in nonclinical subjects. Journal of Clinical Psychology, 57(6), 815-828.

Clinical Applications:

• Malloy-Diniz, L. F., Fuentes, D., Leite, W. B., Correa, H., & Bechara, A. (2007). Impulsive behavior in adults with attention deficit/hyperactivity disorder: Characterization of attentional, motor and cognitive impulsiveness. Journal of the International Neuropsychological Society, 13(4), 693-698.
• Moeller, F. G., Barratt, E. S., Dougherty, D. M., Schmitz, J. M., & Swann, A. C. (2001). Psychiatric aspects of impulsivity. American Journal of Psychiatry, 158(11), 1783-1793.

Personality and Behavioral Research:

• Reynolds, B., Ortengren, A., Richards, J. B., & de Wit, H. (2006). Dimensions of impulsive behavior: Personality and behavioral measures. Personality and Individual Differences, 40(2), 305-315.
• Whiteside, S. P., & Lynam, D. R. (2001). The Five Factor Model and impulsivity: Using a structural model of personality to understand impulsivity. Personality and Individual Differences, 30(4), 669-689.

Developmental Research:

• Steinberg, L., Albert, D., Cauffman, E., Banich, M., Graham, S., & Woolard, J. (2008). Age differences in sensation seeking and impulsivity as indexed by behavior and self-report: Evidence for a dual systems model. Developmental Psychology, 44(6), 1764-1778.