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

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: (i) to identify the optimal trans-diagnostic structural framework for measuring impulsive and compulsive problem behaviours; and (ii) to use this optimal framework to identify common/distinct antecedents of these latent phenotypes. Methods 654 young adults were recruited as part of the Neuroscience in Psychiatry Network (NSPN), 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 (PLS). 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. Conclusions This study demonstrates that trans-diagnostic phenotypes of 33 impulsive and compulsive problem behaviours are identifiable in young adults, utilizing 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.