Brain and Mental Health Research Hub,Monash Institute of Cognitive and Clinical Neurosciences and School of Psychological Sciences,Monash University,Clayton,Victoria,Australia.
CNS Spectr. 2019 Aug;24(4):426-440. doi: 10.1017/S1092852918001244. Epub 2018 Nov 21.
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.
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.
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.
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.
冲动性和强迫性已被认为是具有重要的跨诊断维度表型，与成瘾有关。我们旨在开发一种模型，将这些结构概念化为重叠的维度表型，并测试该模型的不同组成部分是否解释了成瘾和相关行为的共发性。
通过亚马逊的 Mechanical Turk 招募了一个由大量成年人（N=487）组成的样本，并完成了自我报告问卷，测量冲动性、不确定性容忍度、强迫观念和 6 种成瘾和相关行为的严重程度。层次聚类用于将成瘾行为组织成反映其共发性的同质组。结构方程模型用于评估冲动性和强迫性的假设双因素模型的拟合度，并确定模型每个组成部分对成瘾和相关行为共发性的解释比例。
成瘾和相关行为聚类为 2 个不同的组：冲动控制问题，包括有害饮酒、病态赌博和强迫性购买；以及强迫性-相关问题，包括强迫症状、暴食和网络成瘾。冲动性和强迫性的假设双因素模型提供了最佳的经验拟合度，有 3 个不相关的因素对应于一般的抑制障碍维度，以及特定的冲动性和强迫性维度。这些维度表型独特且累加性地解释了冲动控制问题和强迫性相关问题中 39.9%和 68.7%的总方差。
将冲动性和强迫性表示为重叠的维度表型的模型，对于理解成瘾和相关行为在共同病因、共病和潜在的跨诊断治疗方面具有重要意义。
