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 behaviors 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 behaviors; 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 behaviors was identified. Baseline predictors of subsequent impulsive and compulsive trans-diagnostic phenotypes were characterized, along with cross-sectional associations, using Partial Least Squares (PLS). Results: Current problem behaviors were optimally explained by a bi-factor model, which yielded dissociable measures of impulsivity and compulsivity, as well as a general factor. Impulsive problem behaviors were significantly explained by prior antisocial and impulsive personality traits, male gender, general distress, perceived dysfunctional parenting, and teasing/arguments within friendships. Compulsive problem behaviors were significantly explained by prior compulsive traits, and female gender. Conclusions: This study demonstrates that trans-diagnostic phenotypes of 33 impulsive and compulsive problem behaviors 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 behaviors.