The computational and neural substrates of individual differences in impulsivity under loss framework.

Numerous neuroimaging studies have identified significant individual variability in intertemporal choice, often attributed to three neural mechanisms: (1) increased reward circuit activity, (2) decreased cognitive control, and (3) prospection ability. These mechanisms that explain impulsivity, however, have been primarily studied in the gain domain. This study extends this investigation to the loss domain. We employed a hierarchical Bayesian drift-diffusion model (DDM) and the inter-subject representational similarity approach (IS-RSA) to investigate the potential computational neural substrates underlying impulsivity in loss domain across two experiments (n = 155). These experiments utilized a revised intertemporal task that independently manipulated the amounts of immediate and delayed-loss options. Behavioral results demonstrated positive correlations between the drift rate, measured by the DDM, and the impulsivity index K in Exp. 1 (n = 97) and were replicated in Exp. 2 (n = 58). Imaging analyses further revealed that the drift rate significantly mediated the relations between brain properties (e.g., prefrontal cortex activations and gray matter volume in the orbitofrontal cortex and precuneus) and K in Exp. 1. IS-RSA analyses indicated that variability in the drift rate also mediated the associations between inter-subject variations in activation patterns and individual differences in K. These findings suggest that individuals with similar impulsivity levels are likely to exhibit similar value processing patterns, providing a potential explanation for individual differences in impulsivity within a loss framework.

The functional connectivity between right insula and anterior cingulate cortex underlying the association between future self-continuity and delay discounting.

Delay discounting refers to the tendency of individuals to devalue future rewards as the delay in their receipt increases over time. Previous studies have indicated that future self-continuity correlates with delay discounting rates. However, the neural basis underlying the relationship between future self-continuity and delay discounting is not clear. To address this question, we used voxel-based morphometry and resting-state functional connectivity analyses to investigate the neural basis underlying the association between future self-continuity and delay discounting. Behavioral result showed that future self-continuity was positively associated with delay discounting. Voxel-based morphometry analysis result indicated that gray matter volume in the right dorsal anterior insula was positively correlated with future self-continuity. Resting-state functional connectivity analysis found that functional connectivity between the right dorsal anterior insula and anterior cingulate cortex was positively associated with future self-continuity. Mediation analysis showed that the right dorsal anterior insula-right anterior cingulate cortex functional connectivity partially mediated the relationship between future self-continuity and delay discounting. These results suggested that right dorsal anterior insula-right anterior cingulate cortex functional connectivity could be the neural basis underlying the association between future self-continuity and delay discounting. In summary, the study provided novel insights into how future self-continuity affected delay discounting and offers new explanations from a neural perspective.

Dopamine and acetylcholine have distinct roles in delay- and effort-based decision-making in humans.

In everyday life, we encounter situations that require tradeoffs between potential rewards and associated costs, such as time and (physical) effort. The literature indicates a prominent role for dopamine in discounting of both delay and effort, with mixed findings for delay discounting in humans. Moreover, the reciprocal antagonistic interaction between dopaminergic and cholinergic transmission in the striatum suggests a potential opponent role of acetylcholine in these processes. We found opposing effects of dopamine D2 (haloperidol) and acetylcholine M1 receptor (biperiden) antagonism on specific components of effort-based decision-making in healthy humans: haloperidol decreased, whereas biperiden increased the willingness to exert physical effort. In contrast, delay discounting was reduced under haloperidol, but not affected by biperiden. Together, our data suggest that dopamine, acting at D2 receptors, modulates both effort and delay discounting, while acetylcholine, acting at M1 receptors, appears to exert a more specific influence on effort discounting only.

Running away from the marshmallow: the relevance of behaviour settings for a situated science of self-control.

The behaviour settings approach was introduced as a means to study the variability of human beings' behaviour outside the lab. More recently, it has been argued that it also provides a fruitful avenue for developing situated accounts of cognition. This article will provide a proof of concept for the latter suggestion, focusing on the science of self-control. Self-control is the ability of individuals to pursue goals they value in the face of conflicting motivations. The hypothesis we bring forward is that this ability should be understood as a set of skills by which individuals modulate their relation to their environment, more specifically the behaviour settings they inhabit. With this conception of self-control in hand, we will take a critical look at well-known experiments involving delayed gratification tasks and propose concrete suggestions on how to improve them. This will bring us to the conclusion that the behaviour settings framework might have a valuable role to play in developing a situated science of self-control. This article is part of the theme issue 'People, places, things and communities: expanding behaviour settings theory in the twenty-first century'.

Healthy dietary choices involve prefrontal mechanisms associated with long-term reward maximization but not working memory.

Taste and health are critical factors to be considered when choosing foods. Prioritizing healthiness over tastiness requires self-control. It has also been suggested that self-control is guided by cognitive control. We then hypothesized that neural mechanisms underlying healthy food choice are associated with both self-control and cognitive control. Human participants performed a food choice task and a working memory task during functional MRI scanning. Their degree of self-control was assessed behaviorally by the value discount of delayed monetary rewards in intertemporal choice. Prioritizing healthiness in food choice was associated with greater activity in the superior, dorsolateral, and medial prefrontal cortices. Importantly, the prefrontal activity was greater in individuals with smaller delay discounting (i.e. high self-control) who preferred a delayed larger reward to an immediate smaller reward in intertemporal choice. On the other hand, working memory activity did not show a correlation with delay discounting or food choice activity, which was further supported by supplementary results that analyzed data from the Human Connectome Project. Our results suggest that the prefrontal cortex plays a critical role in healthy food choice, which requires self-control, but not working memory, for maximization of reward attainments in a remote future.

Assessing the relationship between delay discounting and decisions to engage in various protective behaviors during COVID-19.

Research suggests that discounting of delayed rewards (i.e., tendency to choose smaller immediate rewards over large later rewards) is a promising target of intervention to encourage compliance with public health measures (PHM), such as vaccination compliance. The effects of delay discounting, however, may differ across the types of PHMs, given that the benefits of vaccination, unlike other PHMs (physical distancing, handwashing, and mask-wearing), are more temporally delayed. Here, we examined whether delay discounting predicts engaging in COVID-19 PHMs in approximately 7,000 participants recruited from 13 countries in June-August 2021. After controlling for demographic and distress variables, delay discounting was a negative predictor of vaccination, but a positive predictor of physical distancing (when restrictions are in place) and handwashing. There was no significant association between delay discounting and frequency of mask-wearing. It is possible that increasing vaccination compliance may require greater emphasis on future benefits of vaccination, whereas promotion of physical distancing and hand hygiene may require greater focus on the present moment. Further research is needed to investigate the nature of this relationship and its implications for public health messaging.

Differential phase-amplitude coupling in nucleus accumbens and orbitofrontal cortex reflects decision-making during a delay discounting task.

BACKGROUND: The impulsive choice is characterized by the preference for a small immediate reward over a bigger delayed one. The mechanisms underlying impulsive choices are linked to the activity in the Nucleus Accumbens (NAc), the orbitofrontal cortex (OFC), and the dorsolateral striatum (DLS). While the study of functional connectivity between brain areas has been key to understanding a variety of cognitive processes, it remains unclear whether functional connectivity differentiates impulsive-control decisions. METHODS: To study the functional connectivity both between and within NAc, OFC, and DLS during a delay discounting task, we concurrently recorded local field potential in NAc, OFC, and DLS in rats. We then quantified the degree of phase-amplitude coupling (PAC), coherence, and Granger Causality between oscillatory activities in animals exhibiting either a high (HI) or low (LI) tendency for impulsive choices. RESULTS: Our results showed a differential pattern of PAC during decision-making in OFC and NAc, but not in DLS. While theta-gamma PAC in OFC was associated with self-control decisions, a higher delta-gamma PAC in both OFC and NAc biased decisions toward impulsive choices in both HI and LI groups. Furthermore, during the reward event, Granger Causality analysis indicated a stronger NAc➔OFC gamma contribution in the HI group, while the LI group showed a higher OFC➔NAc gamma contribution. CONCLUSIONS: The overactivity in NAc during reward in the HI group suggests that exacerbated contribution of NAcCore can lead to an overvaluation of reward that biases the behavior toward the impulsive choice.

Reward value and internal state differentially drive impulsivity and motivation.

Goal-directed behavior is influenced by both reward value as well as internal state. A large body of research has focused on how reward value and internal drives such as hunger influence motivation in rodent models, however less work has focused on how these factors may differentially affect impulsivity. In these studies, we tested the effect of internal drive versus reward value on different facets of reward-related behavior including impulsive action, impulsive choice and, motivation. We varied reward value by changing the concentration of sucrose in the reward outcome, and varied internal drive by manipulating thirst through water restriction. Consistent with the literature we found that both internal state and reward value influenced motivation. However, we found that in high effort paradigms, only internal state influenced motivation with minimal effects of reward value. Interestingly, we found that internal state and reward value differentially influence different subtypes of impulsivity. Internal state, and to a lesser extent, reward value, influenced impulsive action as measured by premature responding. On the other hand, there were minimal effects of either reward value or homeostatic state on impulsive choice as measured by delay discounting. Overall, these studies begin to address how internal state and reward value differentially drive impulsive behavior. Understanding how these factors influence impulsivity is important for developing behavioral interventions and treatment targets for patients with dysregulated motivated or impulsive behavior.

Involvement of dopamine D3 receptor in impulsive choice decision-making in male rats.

Impulsive decision-making has been linked to impulse control disorders and substance use disorders. However, the neural mechanisms underlying impulsive choice are not fully understood. While previous PET imaging and autoradiography studies have shown involvement of dopamine and D2/3 receptors in impulsive behavior, the roles of distinct D1, D2, and D3 receptors in impulsive decision-making remain unclear. In this study, we used a food reward delay-discounting task (DDT) to identify low- and high-impulsive rats, in which low-impulsive rats exhibited preference for large delayed reward over small immediate rewards, while high-impulsive rats showed the opposite preference. We then examined D1, D2, and D3 receptor gene expression using RNAscope in situ hybridization assays. We found that high-impulsive male rats exhibited lower levels of D2 and D3, and particularly D3, receptor expression in the nucleus accumbens (NAc), with no significant changes in the insular, prelimbic, and infralimbic cortices. Based on these findings, we further explored the role of the D3 receptor in impulsive decision-making. Systemic administration of a selective D3 receptor agonist (FOB02-04) significantly reduced impulsive choices in high-impulsive rats but had no effects in low-impulsive rats. Conversely, a selective D3 receptor antagonist (VK4-116) produced increased both impulsive and omission choices in both groups of rats. These findings suggest that impulsive decision-making is associated with a reduction in D3 receptor expression in the NAc. Selective D3 receptor agonists, but not antagonists, may hold therapeutic potentials for mitigating impulsivity in high-impulsive subjects.

Associations between behavioral and self-reported impulsivity, brain structure, and genetic influences in middle childhood.

Impulsivity undergoes a normative developmental trajectory from childhood to adulthood and is thought to be driven by maturation of brain structure. However, few large-scale studies have assessed associations between impulsivity, brain structure, and genetic susceptibility in children. In 9112 children ages 9-10 from the ABCD study, we explored relationships among impulsivity (UPPS-P impulsive behavior scale; delay discounting), brain structure (cortical thickness (CT), cortical volume (CV), and cortical area (CA)), and polygenic scores for externalizing behavior (PGSEXT). Both higher UPPS-P total scores and more severe delay-discounting had widespread, low-magnitude associations with smaller CA in frontal and temporal regions. No associations were seen between impulsivity and CV or CT. Additionally, higher PGSEXT was associated with both higher UPPS-P scores and with smaller CA and CV in frontal and temporal regions, but in non-overlapping cortical regions, underscoring the complex interplay between genetics and brain structure in influencing impulsivity. These findings indicate that, within large-scale population data, CA is significantly yet weakly associated with each of these impulsivity measures and with polygenic risk for externalizing behaviors, but in distinct brain regions. Future work should longitudinally assess these associations through adolescence, and examine associated functional outcomes, such as future substance use and psychopathology.

Effects of delay sequence in a delay discounting task.

Delay discounting refers to the decrease in subjective value of a reward as the delay until its receipt increases. In the present study we assessed the effects of the sequence of delay blocks (increasing or decreasing) on discounting and the data systematicity using a titrating procedure with human participants. All participants completed the delay discounting task in both an increasing and decreasing sequence of delays. Delays ranged from one day to ten years. We found steeper discounting when the delays were presented in an increasing sequence compared with when they were presented in a decreasing sequence. We also found steeper discounting when participants completed the increasing sequence condition first. Our results agree with other findings reported in the literature and suggest that delay discounting may be affected by prior and subsequent experience.

Orbitostriatal encoding of reward delayed gratification and impulsivity in chronic pain.

Central robust network functional rearrangement is a characteristic of several neurological conditions, including chronic pain. Preclinical and clinical studies have shown the importance of pain-induced dysfunction in both orbitofrontal cortex (OFC) and nucleus accumbens (NAc) brain regions for the emergence of cognitive deficits. Outcome information processing recruits the orbitostriatal circuitry, a pivotal pathway regarding context-dependent reward value encoding. The current literature reveals the existence of structural and functional changes in the orbitostriatal crosstalk in chronic pain conditions, which have emerged as a possible underlying cause for reward and time discrimination impairments observed in individuals affected by such disturbances. However, more comprehensive investigations are needed to elucidate the underlying disturbances that underpin disease development. In this review article, we aim to provide a comprehensive view of the orbitostriatal mechanisms underlying time-reward dependent behaviors, and integrate previous findings on local and network malplasticity under the framework of the chronic pain sphere.

Brain Stimulation of Dorsolateral Prefrontal Cortices Influences Impulsivity in Delay Discounting Choices.

Intertemporal decision-making is pivotal for human interests and health. Recently, studies instructed participants to make intertemporal choices for both themselves and others, but the specific mechanisms are still debated. To address the issue, in the current study, the cost-unneeded conditions (i.e., "Self Immediately - Self Delay" and "Other Immediately - Other Delay" conditions) and the cost-needed conditions (i.e., "Self Immediately - Other Delay" and "Self Delay - Other Immediately" conditions) were set with the identity of OTHER being a stranger. We manipulated the magnitude of reward (Experiment 1) and disrupted the activation of the dorsolateral prefrontal cortex with repetitive transcranial magnetic stimulation (rTMS; Experiment 2). We found that both the behavioral and rTMS manipulations increased smaller but sooner choice probability via reducing self-control function. The reduced self-control function elicited by rTMS affected both self- and other-related intertemporal choices via increasing the choice preference for smaller but sooner reward options, which may help people deeply understand the relationship between self- and other-related intertemporal choices in processing mechanism, especially when the OTHER condition is set as a stranger.

Approaching future rewards or waiting for them to arrive: Spatial representations of time and intertemporal choice.

Our mental representation of the passage of time is structured by concepts of spatial motion, including an ego-moving perspective in which the self is perceived as approaching future events and a time-moving perspective in which future events are perceived as approaching the self. While previous research has found that processing spatial information in one's environment can preferentially activate either an ego-moving or time-moving temporal perspective, potential downstream impacts on everyday decision-making have received less empirical attention. Based on the idea people may feel closer to positive events they see themselves as actively approaching rather than passively waiting for, in this pre-registered study we tested the hypothesis that spatial primes corresponding to an ego-moving (vs. time-moving) perspective would attenuate temporal discounting by making future rewards feel more proximal. 599 participants were randomly assigned to one of three spatial prime conditions (ego-moving, time-moving, control) resembling map-based tasks people may engage with on digital devices, before completing measures of temporal perspective, perceived wait time, perceived control over time, and temporal discounting. Partly consistent with previous research, the results indicated that the time-moving prime successfully activated the intended temporal perspective-though the ego-moving prime did not. Contrary to our primary hypotheses, the spatial primes had no effect on either perceived wait time or temporal discounting. Processing spatial information in a map-based task therefore appears to influence how people conceptualise the passage of time, but there was no evidence for downstream effects on intertemporal preferences. Additionally, exploratory analysis indicated that greater perceived control over time was associated with lower temporal discounting, mediated by a reduction in perceived wait time, suggesting a possible area for future research into individual differences and interventions in intertemporal decision-making.

Is impulsivity related to attentional bias in cigarette smokers? An exploration across levels of nicotine dependency and deprivation.

Research has largely focused on how attentional bias to smoking-related cues and impulsivity independently influence the development and maintenance of cigarette smoking, with limited exploration of the relationship between these mechanisms. The current experiments systematically assessed relationships between multiple dimensions of impulsivity and attentional bias, at different stages of attention, in smokers varying in nicotine dependency and deprivation. Nonsmokers (NS; n  = 26), light-satiated smokers (LS; n  = 25), heavy-satiated smokers (HS; n  = 23) and heavy 12-hour nicotine-deprived smokers (HD; n  = 30) completed the Barratt Impulsivity Scale, delayed discounting task, stop-signal task, information sampling task and a visual dot-probe assessing initial orientation (200 ms) and sustained attention (2000 ms) toward smoking-related cues. Sustained attention to smoking-related cues was present in both HS and LS, while initial orientation bias was only evident in HS. HS and LS also had greater levels of trait motor and nonplanning impulsivity and heightened impulsive choice on the delay discounting task compared with NS, while heightened trait attentional impulsivity was only found in HS. In contrast, in HD, nicotine withdrawal was associated with no attentional bias but heightened reflection impulsivity, poorer inhibitory control and significantly lower levels of impulsive choice relative to satiated smokers. Trait and behavioral impulsivity were not related to the extent of attentional bias to smoking-related cues at any stage of attention, level of nicotine dependency or state of deprivation. Findings have both clinical and theoretical implications, highlighting the unique and independent roles impulsivity and attentional bias may play at different stages of the nicotine addiction cycle.

The sign effect in temporal discounting does not require the hippocampus.

When considering future outcomes, humans tend to discount gains more than losses. This phenomenon, referred to as the temporal discounting sign effect, is thought to result from the greater anticipated emotional impact of waiting for a negative outcome (dread) compared to waiting for a positive outcome (mixture of savoring and impatience). The impact of such anticipatory emotions has been proposed to rely on episodic future thinking. We evaluated this proposal by examining the presence and magnitude of a sign effect in the intertemporal decisions of individuals with hippocampal amnesia, who are severely impaired in their ability to engage in episodic mental simulation, and by comparing their patterns of choices to those of healthy controls. We also measured loss aversion, the tendency to assign greater value to losses compared to equivalent gains, to verify that any reduction in the sign effect in the hippocampal lesion group could not be explained by a group difference in loss aversion. Results showed that participants with hippocampal amnesia exhibited a sign effect, with less discounting of monetary losses compared to gains, that was similar in magnitude to that of controls. Loss aversion, albeit greater in the hippocampal compared to the control group, did not account for the sign effect. These results indicate that the sign effect does not depend on the integrity of hippocampally mediated episodic processes. They suggest instead that the impact of anticipatory emotions can be factored into decisions via semantic future thinking, drawing on non-contextual knowledge about oneself.

Differences in Discounting Behavior and Brain Responses for Food and Money Reward.

Most neuroeconomic research seeks to understand how value influences decision-making. The influence of reward type is less well understood. We used functional magnetic resonance imaging (fMRI) to investigate delay discounting of primary (i.e., food) and secondary rewards (i.e., money) in 28 healthy, normal-weighted participants (mean age = 26.77; 18 females). To decipher differences in discounting behavior between reward types, we compared how well-different option-based statistical models (exponential, hyperbolic discounting) and attribute-wise heuristic choice models (intertemporal choice heuristic, dual reasoning and implicit framework theory, trade-off model) captured the reward-specific discounting behavior. Contrary to our hypothesis of different strategies for different rewards, we observed comparable discounting behavior for money and food (i.e., exponential discounting). Higher k values for food discounting suggest that individuals decide more impulsive if confronted with food. The fMRI revealed that money discounting was associated with enhanced activity in the right dorsolateral prefrontal cortex, involved in executive control; the right dorsal striatum, associated with reward processing; and the left hippocampus, involved in memory encoding/retrieval. Food discounting, instead, was associated with higher activity in the left temporoparietal junction suggesting social reinforcement of food decisions. Although our findings do not confirm our hypothesis of different discounting strategies for different reward types, they are in line with the notion that reward types have a significant influence on impulsivity with primary rewards leading to more impulsive choices.

The unified tradeoff model.

Evidence is steadily mounting that attribute-based models offer a more accurate description of intertemporal choices than traditional alternative-based models. Among the attribute-based models, the tradeoff model offers the broadest coverage of research findings, but at the cost of considerable complexity: There now are various instantiations of the model dealing with partially overlapping universes of choice options and preference patterns. Moreover, there are reports of preference patterns in intertemporal decisions about monetary losses that contradict all attribute-based models proposed so far. Taking stock of these core challenges, and all other evidence, we develop an account of intertemporal choice, the unified tradeoff model, that is simpler, yet more comprehensive, than all currently available versions of the tradeoff model taken together. It borrows extensively from its predecessors, but it introduces a new element, time bias, that enables it to accommodate an extraordinarily broad range of preference patterns, and also generate new predictions that contradict all existing models of intertemporal choice. We report four studies that test and confirm its predictions regarding delay, interval, sign, and magnitude dependence in choices between single-dated outcomes, and a fifth study that tests and confirms its predictions regarding the relation between delay preference in choices that only involve single-dated payments and duration preference in choices that also involve sequences of payments. Having subjected the unified tradeoff model to an elevated risk of disconfirmation, we discuss its parsimony and scope in relation to yet other phenomena, most notably, preference patterns in consumption decisions, the final frontier for attribute-based models. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Child inhibited temperament and caregiver distraction encouragement jointly predict children's delay of gratification competencies.

A cool attentional focus during the classic delay of gratification (DG) task involves shifting attention away from the emotion-arousing features and is a key mechanism that underlies children's ability to resist temptation and wait. Yet, we know relatively little about what gives rise to individual differences in cool focus in the first place. The current study (N = 162, Mage = 6.86 years) addressed this question by focusing on key aspects of child temperament (i.e., behavioral inhibition, BI) and caregiver emotion socialization (i.e., distraction encouragement) as joint predictors of cool focus. We theorized that because children are left alone in an unfamiliar environment for an undefined duration, the DG task would be especially taxing for children higher in BI, hindering their ability to deploy a cool focus and wait. We also reasoned that caregiver encouragement of distraction would serve as a protective factor by allowing children higher in BI to more easily activate a cool focus even when experiencing a taxing task. Results were partially consistent with these hypotheses, shedding new light on precursors to a central ingredient of DG ability.

Developmental deviation in delay discounting as a transdiagnostic indicator of risk for child psychopathology.

BACKGROUND: The tendency to prefer smaller, immediate rewards over larger, delayed rewards is known as delay discounting (DD). Developmental deviations in DD may be key in characterizing psychiatric and neurodevelopmental disorders. Recent work empirically supported DD as a transdiagnostic process in various psychiatric disorders. Yet, there is a lack of research relating developmental changes in DD from mid-childhood to adolescence to psychiatric and neurodevelopmental disorders. Additionally, examining the interplay between socioeconomic status/total household income (THI) and psychiatric symptoms is vital for a more comprehensive understanding of pediatric pathology and its complex relationship with DD. METHODS: The current study addresses this gap in a robust psychiatric sample of 1843 children and adolescents aged 5-18 (M = 10.6, SD = 3.17; 1,219 males, 624 females). General additive models (GAMs) characterized the shape of age-related changes in monetary and food reward discounting for nine psychiatric disorders compared with neurotypical youth (NT; n = 123). Over 40% of our sample possessed a minimum of at least three psychiatric or neurodevelopmental disorders. We used bootstrap-enhanced Louvain community detection to map DD-related comorbidity patterns. We derived five subtypes based on diagnostic categories present in our sample. DD patterns were then compared across each of the subtypes. Further, we evaluated the effect of cognitive ability, emotional and behavioral problems, and THI in relation to DD across development. RESULTS: Higher discounting was found in six of the nine disorders we examined relative to NT. DD was consistently elevated across development for most disorders, except for depressive disorders, with age-specific DD differences compared with NTs. Community detection analyses revealed that one comorbidity subtype consisting primarily of Attention-Deficit/Hyperactivity Disorder (ADHD) Combined Presentation and anxiety disorders displayed the highest overall emotional/behavioral problems and greater DD for the food reward. An additional subtype composed mainly of ADHD, predominantly Inattentive Presentation, learning, and developmental disorders, showed the greatest DD for food and monetary rewards compared with the other subtypes. This subtype had deficits in reasoning ability, evidenced by low cognitive and academic achievement performance. For this ADHD-I and developmental disorders subtype, THI was related to DD across the age span such that participants with high THI showed no differences in DD compared with NTs. In contrast, participants with low THI showed significantly worse DD trajectories than all others. Our results also support prior work showing that DD follows nonlinear developmental patterns. CONCLUSIONS: We demonstrate preliminary evidence for DD as a transdiagnostic marker of psychiatric and neurodevelopmental disorders in children and adolescents. Comorbidity subtypes illuminate DD heterogeneity, facilitating the identification of high-risk individuals. Importantly, our findings revealed a marked link between DD and intellectual reasoning, with children from lower-income households exhibiting lower reasoning skills and heightened DD. These observations underscore the potential consequences of compromised self-regulation in economically disadvantaged individuals with these disorders, emphasizing the need for tailored interventions and further research to support improved outcomes.