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Neural substrates of trait impulsivity, anhedonia, and irritability: Mechanisms of heterotypic comorbidity between externalizing disorders and unipolar depression

Published online by Cambridge University Press:  14 October 2016

Aimee Zisner  and
Theodore P. Beauchaine
Aimee Zisner
Affiliation:
The Ohio State University
Theodore P. Beauchaine*
Affiliation:
The Ohio State University
*
Address correspondence and reprint requests to: Theodore P. Beauchaine, Department of Psychology, The Ohio State University, 225 Psychology Building, 1835 Neil Avenue, Columbus, OH 43210; E-mail: beauchaine.1@osu.edu.
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Abstract

Trait impulsivity, which is often defined as a strong preference for immediate over delayed rewards and results in behaviors that are socially inappropriate, maladaptive, and short-sighted, is a predisposing vulnerability to all externalizing spectrum disorders. In contrast, anhedonia is characterized by chronically low motivation and reduced capacity to experience pleasure, and is common to depressive disorders. Although externalizing and depressive disorders have virtually nonoverlapping diagnostic criteria in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, heterotypic comorbidity between them is common. Here, we review common neural substrates of trait impulsivity, anhedonia, and irritability, which include both low tonic mesolimbic dopamine activity and low phasic mesolimbic dopamine responding to incentives during reward anticipation and associative learning. We also consider how other neural networks, including bottom-up emotion generation systems and top-down emotion regulation systems, interact with mesolimbic dysfunction to result in alternative manifestations of psychiatric illness. Finally, we present a model that emphasizes a translational, transdiagnostic approach to understanding externalizing/depression comorbidity. This model should refine ways in which internalizing and externalizing disorders are studied, classified, and treated.

Type
Special Issue Articles
Information
Development and Psychopathology , Volume 28 , Special Issue 4pt1: Mechanisms of Comorbidity, Continuity, and Discontinuity in Psychopathology , November 2016 , pp. 1177 - 1208
Copyright
Copyright © Cambridge University Press 2016 

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