Decoding anxiety–impulsivity subtypes in preadolescent internalising disorders: findings from the Adolescent Brain Cognitive Development study

作者：Huaxin Fan, Zhaowen Liu, Xinran Wu, Gechang Yu, Xinrui Gu, Nanyu Kuang, Kai Zhang, Yu Liu, Tianye Jia, Barbara J. Sahakian, Trevor W. Robbins, Günter Schumann, Wei Cheng, Jianfeng Feng, Benjamin Becker, Jie Zhang · 发表于：The British Journal of Psychiatry · 年份：2023 · DOI：10.1192/bjp.2023.107 · 被引用次数：52 · 研究领域：Child and Adolescent Psychosocial and Emotional Development、Obsessive-Compulsive Spectrum Disorders、Personality Disorders and Psychopathology

BACKGROUND: Internalising disorders are highly prevalent emotional dysregulations during preadolescence but clinical decision-making is hampered by high heterogeneity. During this period impulsivity represents a major risk factor for psychopathological trajectories and may act on this heterogeneity given the controversial anxiety-impulsivity relationships. However, how impulsivity contributes to the heterogeneous symptomatology, neurobiology, neurocognition and clinical trajectories in preadolescent internalising disorders remains unclear. AIMS: The aim was to determine impulsivity-dependent subtypes in preadolescent internalising disorders that demonstrate distinct anxiety-impulsivity relationships, neurobiological, genetic, cognitive and clinical trajectory signatures. METHOD: We applied a data-driven strategy to determine impulsivity-related subtypes in 2430 preadolescents with internalising disorders from the Adolescent Brain Cognitive Development study. Cross-sectional and longitudinal analyses were employed to examine subtype-specific signatures of the anxiety-impulsivity relationship, brain morphology, cognition and clinical trajectory from age 10 to 12 years. RESULTS: We identified two distinct subtypes of patients who internalise with comparably high anxiety yet distinguishable levels of impulsivity, i.e. enhanced (subtype 1) or decreased (subtype 2) compared with control participants. The two subtypes exhibited opposing anxiety-impulsivity relationships: higher anxi...