Fractionation of impulsive and compulsive trans-diagnostic phenotypes and their longitudinal associations

Abstract

Objective: Young adulthood is a crucial neurodevelopmental period during which impulsive and compulsive problem behaviours commonly emerge. While traditionally considered diametrically opposed, impulsive and compulsive symptoms tend to co-occur. The objectives of this study were as follows: (a) to identify the optimal trans-diagnostic structural framework for measuring impulsive and compulsive problem behaviours, and (b) to use this optimal framework to identify common/distinct antecedents of these latent phenotypes. Method: In total, 654 young adults were recruited as part of the Neuroscience in Psychiatry Network, a population-based cohort in the United Kingdom. The optimal trans-diagnostic structural model capturing 33 types of impulsive and compulsive problem behaviours was identified. Baseline predictors of subsequent impulsive and compulsive trans-diagnostic phenotypes were characterised, along with cross-sectional associations, using partial least squares. Results: Current problem behaviours were optimally explained by a bi-factor model, which yielded dissociable measures of impulsivity and compulsivity, as well as a general disinhibition factor. Impulsive problem behaviours were significantly explained by prior antisocial and impulsive personality traits, male gender, general distress, perceived dysfunctional parenting and teasing/arguments within friendships. Compulsive problem behaviours were significantly explained by prior compulsive traits and female gender. Conclusion: This study demonstrates that trans-diagnostic phenotypes of 33 impulsive and compulsive problem behaviours are identifiable in young adults, utilising a bi-factor model based on responses to a single questionnaire. Furthermore, these phenotypes have different antecedents. The findings yield a new framework for fractionating impulsivity and compulsivity, and suggest different early intervention targets to avert emergence of problem behaviours. This framework may be useful for future biological and clinical dissection of impulsivity and compulsivity.

Compulsivity is measurable across distinct psychiatric symptom domains and is associated with familial risk and reward-related attentional capture

“…By identifying latent phenotypes that are dimensional in nature, existing in milder forms in the background population, and in more extreme forms across mental disorders, it is hoped that progress can be made in improving early detection, diagnostic classification systems, neurobiological models, and treatment approaches. [6][7][8] The Cambridge-Chicago Compulsivity Trait Scale (CHI-T) is a 15-item scale that was recently developed to measure a broad range of compulsive traits. In an initial validation study conducted using in-person clinical assessments, the CHI-T had good psychometric properties, with total scores occupying a normative distribution, and convergent validity being demonstrated against relevant symptoms (correlating with OCD, gambling disorder, and substance use disorder symptoms).…”

Brain micro-architecture and disinhibition: a latent phenotyping study across 33 impulsive and compulsive behaviours

“…Bi-factor modelling of impulsive and compulsive symptoms (primary cohort) Information on impulsive and compulsive symptoms was collected from 654 NSPN participants, who completed the Impulsive-Compulsive Behaviours Checklist (ICBC) [10]. This was achieved by contacting all individuals from the primary cohort via email, and inviting them to complete a follow-up questionnaire comprising more detailed information about impulsive and compulsive problems.…”

“…1. The bi-factor model has superior model fit to the approach of using summary scores, across the full range of fit parameters (Comparative Fit Index, CFI; Root Mean Square Error of Approximation, RMSEA; Weighted Room Mean Square Residual, WRMR; and chi-square test) [10]. As such, the bi-factor approach is clinically preferred, rather than using (for example) the numerical sum of scores from the instrument, because the latter results in marked loss of information content.…”

“…By collecting data regarding 33 types of impulsive and compulsive behaviours in a population sample, it was demonstrated that 70% of expression of these symptoms, within an optimal statistical model, was explained by a latent phenotype termed 'disinhibition' [10]. Conceptually, disinhibition-i.e.…”

“…Given this explanatory power of the latent disinhibition phenotype, coupled with individual differences in myelin-related brain growth during early adulthood [40], understanding the neural mechanisms underpinning this novel latent phenotype is an important next step. Therefore, the primary aim of the current study was to identify relationships between intra-cortical myelination (quantified using MT) and the expression of a latent phenotype of disinhibition [10]; i.e. disinhibition-related myelination.…”