A transdiagnostic dimensional approach to behavioral dysregulation: Examining self-reported reward and punishment sensitivity across psychopathology.

Objective: Theoretically, deficits in reward/punishment sensitivity are considered an essential component associated with behavioral dysregulation, which is characteristic of compulsive-impulsive disorders. However, recent studies have indicated that several disorders are linked to problems with reward/punishment sensitivity, and their results have been inconsistent. This lack of clinical specificity and robustness might reflect more general problems with traditionally diagnostic categories of psychiatry. To address these concerns, we investigated whether a transdiagnostic dimensional approach could more effectively examine clinical associations related to reward/punishment sensitivity for behavioral dysregulation.

Methods: Using multiple psychiatric symptom scores and reward/punishment sensitivity in online general-population samples (N = 19,505), we applied factor analyses to extract transdiagnostic symptom dimensions. Then, we conducted a mixed-effect generalized linear model to examine the relationships between psychopathology and reward/punishment sensitivity.

Results: We extracted three transdiagnostic dimensions, which were validated between two separate datasets: 'Compulsive hypersensitivity (CH), 'Social withdrawal (SW),' and 'Addictive behavior (AB).' While SW was associated with reward sensitivity negatively and punishment sensitivity positively, AB showed opposite associations. On the other hand, CH was positively associated with both sensitivities.

Conclusions: Our results highlight the importance of reward/punishment sensitivity for our understanding of behavioral dysregulation, especially in the compulsive-impulsive dimension. Moreover, these findings underscore how transdiagnostic perspectives contribute to a more powerful examination of reward/punishment deficits than studies focusing on a categorical disorder.