Transdiagnostic mechanisms in internalizing and externalizing psychopathology: The role of effortful control in reflexive responding to emotion

Emotion-based impulsivity is a transdiagnostic construct related to both internalizing and externalizing behaviors. The Reflexive Responding to Emotion (RRE) framework proposes one possible mechanism through which emotion-based impulsivity predicts two phenotypically different presentations – poor effortful control in the face of strong negative and positive affect can result in either approach or avoidance tendencies. In the present study, we tested this theoretical model in a large developmental community sample, the Enhanced NKI-RS sample (Adult n = 708, Adolescent n = 367), which has a wide range of psychopathology and healthy functioning. Using structural equation path modeling, we tested our primary hypothesis that heightened negative or positive affect would be associated with internalizing and externalizing behaviors indirectly through activation control (avoidance) or inhibitory control (approach) facets of effortful control. In adolescents, pathways consistent with the RRE framework for negative urgency emerged such that there was a significant indirect path from negative affect to activation control to internalizing and from negative affect to inhibitory control to externalizing. There was no evidence of positive urgency pathways in the adolescent sample. In contrast, distinct pathways emerged for negative and positive affect in the adult sample – both indirectly led to internalizing psychopathology through activation control and externalizing psychopathology through inhibitory control. Results provide empirical support for the theoretical RRE model and highlight differential cognitive mechanisms through which heightened emotion states may lead to distinct impulsive action or inaction. Implications of these results are discussed, particularly as they relate to differential intervention targets for emotion-based impulsivity in transdiagnostic populations.