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Decoding anxiety-impulsivity subtypes in preadolescent internalising disorders: findings from the Adolescent Brain
Huaxin Fan1, Zhaowen Liu2, Xinran Wu1
1Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, China and Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, China.
The British Journal of Psychiatry : the Journal of Mental Science
|September 20, 2023
Summary
Impulsivity defines distinct subtypes of preadolescent internalizing disorders, revealing varied anxiety links and brain patterns. High impulsivity predicts a worse trajectory, highlighting the need for early intervention in these emotional dysregulations.
Area of Science:
- Neuroscience
- Developmental Psychology
- Psychiatry
Background:
- Internalizing disorders in preadolescence are common emotional dysregulations with high heterogeneity, complicating clinical decisions.
- Impulsivity is a significant risk factor for psychopathological development and may contribute to this heterogeneity, particularly given debated anxiety-impulsivity links.
- The precise role of impulsivity in the varied symptomatology, neurobiology, cognition, and clinical paths of preadolescent internalizing disorders remains unclear.
Purpose of the Study:
- To identify impulsivity-dependent subtypes within preadolescent internalizing disorders.
- To characterize these subtypes based on distinct anxiety-impulsivity relationships.
- To examine subtype-specific neurobiological, genetic, cognitive, and clinical trajectory signatures.
Main Methods:
- A data-driven approach was used to identify impulsivity-related subtypes in 2430 preadolescents with internalizing disorders from the Adolescent Brain Cognitive Development study.
- Cross-sectional and longitudinal analyses examined subtype differences in anxiety-impulsivity relationships, brain morphology, cognition, and clinical trajectories from ages 10 to 12.
- Neurobiological, genetic, and cognitive data were analyzed to identify distinct signatures for each subtype.
Main Results:
- Two distinct subtypes with high anxiety but differing impulsivity levels were identified: subtype 1 (enhanced impulsivity) and subtype 2 (decreased impulsivity).
- Opposing anxiety-impulsivity relationships were observed: higher anxiety correlated with lower perseverance in subtype 1 and lower sensation seeking in subtype 2.
- Subtype 1 showed thicker prefrontal/temporal cortices, genetic links to immune diseases and specific neurotransmitters, cognitive deficits, and a detrimental trajectory with increased dysregulation and suicide risk.
Conclusions:
- Impulsivity defines distinct subtypes of preadolescent internalizing disorders, resolving controversies regarding the anxiety-impulsivity interaction.
- The high-impulsivity subtype is associated with a detrimental clinical trajectory, underscoring the necessity for early intervention.
- These findings offer critical insights for personalized treatment strategies in pediatric mental health.
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