Overlapping dimensional phenotypes of impulsivity and compulsivity explain co-occurrence of addictive and related behaviors (2018)

CNS Spectr. 2018 Nov 21:1-15. doi: 10.1017/S1092852918001244.

Tiego J1, Oostermeijer S1, Prochazkova L1, Parkes L1, Dawson A1, Youssef G1, Oldenhof E1, Carter A1, Segrave RA1, Fontenelle LF1, Yücel M1.

Abstract

OBJECTIVE:

Impulsivity and compulsivity have been implicated as important transdiagnostic dimensional phenotypes with potential relevance to addiction. We aimed to develop a model that conceptualizes these constructs as overlapping dimensional phenotypes and test whether different components of this model explain the co-occurrence of addictive and related behaviors.

METHODS:

A large sample of adults (N=487) was recruited through Amazon’s Mechanical Turk and completed self-report questionnaires measuring impulsivity, intolerance of uncertainty, obsessive beliefs, and the severity of 6 addictive and related behaviors. Hierarchical clustering was used to organize addictive behaviors into homogenous groups reflecting their co-occurrence. Structural equation modeling was used to evaluate fit of the hypothesized bifactor model of impulsivity and compulsivity and determine the proportion of variance explained in the co-occurrence of addictive and related behaviors by each component of the model.

RESULTS:

Addictive and related behaviors clustered into 2 distinct groups: Impulse-Control Problems, consisting of harmful alcohol use, pathological gambling, and compulsive buying, and Obsessive-Compulsive-Related Problems, consisting of obsessive-compulsive symptoms, binge eating, and internet addiction. The hypothesized bifactor model of impulsivity and compulsivity provided the best empirical fit, with 3 uncorrelated factors corresponding to a general Disinhibition dimension, and specific Impulsivity and Compulsivity dimensions. These dimensional phenotypes uniquely and additively explained 39.9% and 68.7% of the total variance in Impulse-Control Problems and Obsessive-Compulsive-Related Problems.

CONCLUSION:

A model of impulsivity and compulsivity that represents these constructs as overlapping dimensional phenotypes has important implications for understanding addictive and related behaviors in terms of shared etiology, comorbidity, and potential transdiagnostic treatments.

KEYWORDS: Addictions; compulsivity; dimensional phenotypes; disinhibition; impulsivity

PMID: 30458896

DOI: 10.1017/S1092852918001244