Human approach-avoidance conflict behaviour relates to transdiagnostic psychiatric symptom dimensions

Approach-avoidance conflict (AAC), a laboratory representation of risky foraging, serves as mainstay of pre-clinical anxiety disorder research, motivated by an impact of anxiolytic drugs on cautious behaviour. While cautiousness appears to be a stable behavioural trait, growing evidence suggests that it is not strongly related to self-reported anxiety. Here, we ask more broadly which psychiatric symptom dimensions relate to AAC behaviour, using a cross-sectional, data-driven, exploration-confirmation approach across two large online samples (N1 = 315; N2 = 690). In a previously validated task, participants chose whether, and when, to approach rewards under varying threat probability and magnitude. They then completed a comprehensive psychiatric questionnaire battery with a known three-factor structure. A broad psychopathology factor, mainly related to impulsivity and OCD symptoms and not specifically linked with anxiety, showed the strongest relation to all behavioural readouts. Higher symptom scores related to decreased passive avoidance, increased behavioural inhibition, and reduced sensitivity to threat features. This factor was also associated with an altered subjective model of threat and reward relations in the environment. Broad and unspecific associations with same directional patterns but smaller magnitudes were found between individual questionnaire scores and behaviour, underscoring the status of transdiagnostic dimensions. Crucially, no associations were found between behaviour and transdiagnostic anxiety-depression, or with gender. This study highlights that cautiousness in AAC tasks is comprised of two components, which are independently associated with transdiagnostic psychopathology but not specifically or particularly strongly with self-reported trait anxiety. Our cross-sectional findings underline the complex interplay of behavioural predispositions and psychopathology.