Temptation Resistance Failures: Transdiagnostic Features and Etiological Influences Across Externalizing and Internalizing Disorders - PROJECT SUMMARY/ABSTRACT Multiple forms of psychopathology involve problems with resisting temptations and urges. Experience sampling (ES) methodology allows the assessment of multiple dissociable facets of temptations, including their intensity and whether they are successfully resisted. Despite their relevance to multiple forms of externalizing psychopathology and certain internalizing conditions, studies applying the ES approach to urges and their resistance have not to date been integrated into research on the structure of psychopathology. Rather, existing ES studies have focused narrowly on specific disorders in isolation (e.g., examining craving for one specific drug while ignoring the multitude of other temptations that the person experiences). Hence, it is still unknown whether individuals with relevant psychopathology display a broad pattern of differences in temptations and their resistance beyond the abused substance or behavior that is the focus of that disorder. Furthermore, it is unknow to what extent observed findings are specific to these individual disorders or reflect transdiagnostic features that contribute to the high comorbidity of conditions across broader dimensions (spectra and superspectra) of psychopathology. We propose to test the hypothesis that the broad ability to successfully resist temptations and urges across temptation classes is associated with the broad externalizing superspectrum, and preferentially its underlying disinhibition spectra as defined by the Hierarchical Taxonomy of Psychopathology (HiTOP). Additional associations are expected to arise between reduced temptation resistance success for specific temptation classes and narrower symptom domains associated with the externalizing and internalizing spectra (e.g., binge eating, nonsuicidal self-harm among internalizing symptoms). We further test genetic and environmental influences on temptation strength and resistance ability with a focus on polygenic scores, adverse childhood experiences and childhood neighborhood deprivation variables that have previously been related to externalizing. Finally, we aim to determine which resistance strategies are the most successful within and across different psychopathology domains (which has direct implications for interventions). To address these issues, we will study 1200 subjects (with enrichment for psychopathology) who will complete two weeks of experience sampling and broad measures of externalizing and internalizing. Because, our ES regimen collects data on the types of temptations and urges, their subjective strength, the goal of the urge (pleasure/relief from negative feelings), the level of conflict with other goals, whether the person attempted to resist the temptation, the resistance strategy, and resistance success, it becomes possible to test the extent to which differences in each of these facets are related to both narrow and broad dimensions of psychopathology. As the most comprehensive transdiagnostic assessment of temptations in psychopathology, the dataset will become a shared resource that allows testing of novel hypotheses about temptations and their resistance in mental health.
